Essential tremor

Essential tremor is a common movement disorder that interferes with the performance of motor tasks and social activities. As a consequence, patients experience a reduction in quality of life. The pathophysiology remains not well understood. Differentiation of essential tremor from other tremor syndromes is important in order for clinicians to better provide patient education and therapy. When pharmacotherapy is indicated, the standard agents remain propranolol and primidone. However, additional agents such as benzodiazepines, gabapentin, topiramate, and zonisamide may provide additional symptomatic benefits. Surgical interventions, such as thalamic deep brain stimulation, and focal injections of botulinum toxin offer patients an alternative treatment modality when oral pharmacotherapy is inadequate. A treatment outline is provided to guide clinicians in the management of patients with essential tremor.