MRCP revision battle 26.7: Essential tremor

Essential tremor can be sporadic or inherited; if inherited its inheritance pattern is believed to be autosomal dominant with incomplete penetrance.

35% of patients with essential tremor will have no family history.


It tends to be worse when the arms are outstretched.


Essential tremor improves with alcohol (not advised as a treatment option!)


Treatment tends to be:

• propranolol
• primidone if propranolol contra-indicated (eg in asthma)

Congratulations on surviving another day's battles!