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Essential tremor — DGM MCQ

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EasyMovement disordersEssential tremorDGM

An 82-year-old man has bilateral hand tremor when drinking tea and writing. There is no bradykinesia, rigidity or gait disturbance. His father had a similar tremor. Current medicines include ramipril. What is the most likely diagnosis?

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Correct answer: D — Essential tremor

A bilateral action tremor with family history and no Parkinsonian features suggests essential tremor. Parkinson's disease usually has bradykinesia and resting tremor, Lewy body dementia has cognitive features, drug-induced Parkinsonism needs exposure, and cerebellar stroke is acute with ataxia. Tremor phenomenology guides diagnosis.

Reference: NICE CKS tremor; NICE NG71