After 40 years, an estimated 4% of people suffer from essential tremors.
The diagnosis may be strongly guided by the presence of another case of essential tremor in the family, but in all cases the diagnosis is based on precise clinical criteria and requires a neurological examination.
Essential tremor is a fairly rapid tremor that occurs during posture (holding a glass) and action (eating, writing). The diagnosis is clinical. The patient’s history and the examination differentiate other disorders, such as Parkinson’s disease, in the majority of cases. There is no specific biological test or imaging of essential tremor.
It is important to look for other causes of tremors, medications such as betamimetics in asthma treatment, toxics such as alcohol or hyperthyroidism etc.
Key clinical differences rule out a diagnosis of Parkinson’s disease and support the clinician’s clinical assessment.
| Criteria | Parkinson's disease | Essential Tremor |
| Type of tremor | Rest | Intentional and postural |
| Age | > 60 years | All ages |
| Family history | Absent | Present in 60% of cases |
| Alcohol | No effect | Reduces tremors |
| Characteristics of tremor | Unilateral | Bilateral |
| Characteristics of tremor | Slow, resting disappears into action | Faster, bilateral, absent at rest, appears in posture and action |
| Other differential signs | Decreased arm swing Rigidity of the limbs, slowness | Normal |
Essential tremor is a progressive disease. The tremor becomes more embarrassing in the gestures of daily life as the disease progresses. The magnitude of the tremor increases and it disturbs the voluntary movements much more, making fine gestures, meals, crafting, writing, etc. very difficult. This development leads to an increase in patients’ disability in personal and professional life.