Essential tremors are the commonest causes of tremors in the world. These are also known as familial tremors or benign tremors. Tremors are often bilateral and commonly involve hands. In some cases, asymmetry may be seen, as in the case shown here, where the tremors are present only in left hand. Tremors can also involve head or voice. Tremors are absent at rest (unlike Parkinson’s disease, where tremors are seen at rest), and are brought on by action such as holding an object, writing or drinking a cup of coffee.
There is no diagnostic test and the diagnosis is made based on the clinical characteristics. Treatment is with medications such as propranolol, topiramate, mysoline or clonazepam. In severe cases, deep brain stimulation surgery may be offered.