© Springer-Verlag Italia 2015
Angelo Sghirlanzoni, Giuseppe Lauria and Luisa Chiapparini (eds.)Prognosis of Neurological Diseases10.1007/978-88-470-5755-5_3232. Extrapyramidal Diseases: Essential Tremor
(1)
Fondazione Giancarlo Quarta-MI, Milan, Italy
Keywords
Movement disordersHyperkinetic syndromesDeep brain stimulationEssential tremorKey Facts
Terminology and definitions – Tremor is a rhythmic and oscillatory movement of a body portion with relatively steady frequency and mutable amplitude. Tremor can appear at “rest,” during postural maintenance and/or action performance
Clinical features – ET is a particular type of action tremor.
Diagnosis
Genetics – ET has often autosomal dominant inheritance; sporadic ET may occur.
Imaging – Nonsignificant.
Neurophysiology – Electromyography shows alternating or unevenly synchronous contractions of reciprocally innervated agonistic and antagonistic muscles.
Top Differential Diagnoses – Parkinson disease; psychogenic tremor; toxic tremor; dystonic tremor; cerebellar disease.
Prognosis
Principles of treatment – Medical: beta-blockers and antiepileptics are the first choice; Surgery: DBS
Disability – Often mild; occasionally, it affects significantly quality of daily living
Abbreviations
DBS, deep brain stimulation; ET, essential tremor; VIM, ventral intermediate nucleus
32.1 Definition
Tremor is a rhythmic and oscillatory movement of a body part with rather steady frequency and flexible amplitude. Tremor is the most usual of all movement disorders. It is due to alternating or unevenly synchronous contractions of reciprocally innervated agonistic and antagonistic muscles. In relation to movement, tremors can be categorized as “rest,” “postural,” or “action.” Essential tremor (ET) (alias hereditary tremor; hereditary tremor; familial tremor; benign idiopathic tremor) is the most common type of action tremor, affecting up to 5–6 % of people over the age of 60 [1].
32.2 Clinical Features
ET is a chronic and gradually progressive disease. It is the most common extrapyramidal disorder, with an estimated overall prevalence of around 0.4–6 %, with no ethnic partiality. Prevalence is highest after the sixth decade.
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