Overview

• Progressive, mainly symmetrical, rhythmic, involuntary oscillation movement disorder of the hands and forearms that is usually absent at rest and present during posture and intentional movements
• Most common form of tremor
• Bimodal Distributions → teens and elderly patients
• Aetiology → positive family history (autosomal dominant inheritance)

Making Diagnosis

Clinical Features:

• Bilateral upper limb action tremor → with absence of other neurological signs
• Worse with sustained voluntary movement (ie. worse when arms outstretched), stress or anxiety
• Involves → hands (90%), head (30%), voice (15%)
• May be accompanied by an intention tremor or resting tremor
• Improves with alcohol consumption

Investigations → clinical diagnosis

Management Plan

• If no dysfunction (mild case) → observation