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Essential Tremor — RACP Adult Medicine MCQ

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EasyNeurologyEssential TremorRACP Adult Medicine

A 40-year-old woman presents with bilateral postural and action tremor (no resting tremor) affecting both hands for 5 years. The tremor improves with alcohol. She has a strong family history of tremor. There is no bradykinesia, rigidity, or gait disturbance. Neurological examination is otherwise normal. What is the most likely diagnosis?

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Correct answer: E — Essential tremor

Bilateral postural/action tremor without bradykinesia, rigidity, or rest tremor, with positive family history and alcohol-responsiveness is essential tremor. It is the most common movement disorder (10× more common than PD). Key distinguishing features from PD: bilateral onset, postural/action tremor (not resting), no bradykinesia, and alcohol responsiveness. Treatment: propranolol or primidone. DBS for refractory cases.

Reference: MDS – 2024 – Essential Tremor; eTG Neurology 2024