Essential Tremor Differential Diagnoses

1. Wagle Shukla, MD. Diagnosis and Treatment of Essential Tremor. CONTINUUM (MINNEAP MINN). 2022. 28(5, MOVEMENT DISORDERS):1333–1349.

2. Bhatia KP, Bain P, Bajaj N, et al. Consensus statement on the classification of tremors. From the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord. 2018. 33(1):75-87.

3. Louis ED, Bares M, Benito-Leon J, et al. Essential tremor-plus: a controversial new concept. Lancet Neurol. 2020. 19(3):266-270.

4. M Bologna G. Paparella, D. Colella, A et Al. Is there evidence of bradykinesia in essential tremor?. European Journal of Neurology. 2020. 27:1501– 1509.

5. Cuberas-Borrós G, Lorenzo-Bosquet C, Aguadé-Bruix S, et al. Quantitative evaluation of striatal I-123-FP-CIT uptake in essential tremor and parkinsonism. Clin Nucl Med. 2011 Nov. 36(11):991-6. [QxMD MEDLINE Link].

6. Antonini A, Berto P, Lopatriello S, Tamma F, Annemans L, Chambers M. Cost-effectiveness of 123I-FP-CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy. Mov Disord. 2008 Nov 15. 23(15):2202-9. [QxMD MEDLINE Link].

7. Tolosa E, Borght TV, Moreno E. Accuracy of DaTSCAN (123I-Ioflupane) SPECT in diagnosis of patients with clinically uncertain parkinsonism: 2-year follow-up of an open-label study. Mov Disord. 2007 Dec. 22(16):2346-51. [QxMD MEDLINE Link].

8. Ferreira JJ, Mestre TA, Lyons KE, et al. MDS evidence-based review of treatments for essential tremor. Mov Disord. 2019. 34(7):950-958.

9. Louis ED. Treatment of Essential Tremor: Are there Issues We are Overlooking?. Front Neurol. 2011. 2:91. [QxMD MEDLINE Link]. [Full Text].

10. Elias WJ, Lipsman N, Ondo WG, Ghanouni P, Kim YG, Lee W, et al. A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor. N Engl J Med. 2016 Aug 25. 375 (8):730-9. [QxMD MEDLINE Link].

11. Walter AR, Bower JH, Ahlskog JE et al. Increased risk of essential tremor in first-degree relative of patients with Parkinson’s disease. Mov Disord. Aug 15 2007. 22(11):

12. Louis ED, Vonsattel JP. The emerging neuropathology of essential tremor. Mov Disord. 2008 Jan 30. 23(2):174-82. [QxMD MEDLINE Link].

13. Shill HA, Adler CH, Sabbagh MN, et al. Pathologic findings in prospectively ascertained essential tremor subjects. Neurology. 2008 Apr 15. 70(16 Pt 2):1452-5. [QxMD MEDLINE Link].

14. Louis ED, Zheng W, Mao X, Shungu DC. Blood harmane is correlated with cerebellar metabolism in essential tremor: a pilot study. Neurology. 2007 Aug 7. 69(6):515-20. [QxMD MEDLINE Link].

15. Louis ED, Honig LS, Vonsattel JP, Maraganore DM, Borden S, Moskowitz CB. Essential tremor associated with focal nonnigral Lewy bodies: a clinicopathologic study. Arch Neurol. 2005 Jun. 62(6):1004-7. [QxMD MEDLINE Link].

16. Louis ED, Vonsattel JP, Honig LS, Ross GW, Lyons KE, Pahwa R. Neuropathologic findings in essential tremor. Neurology. 2006 Jun 13. 66(11):1756-9. [QxMD MEDLINE Link].

17. Shin DH, Han BS, Kim HS, Lee PH. Diffusion tensor imaging in patients with essential tremor. AJNR Am J Neuroradiol. 2008 Jan. 29(1):151-3. [QxMD MEDLINE Link].

18. Bermejo-Pareja F, Louis ED, Benito-Leon J. Risk of incident dementia in essential tremor: a population-based study. Mov Disord. 2007 Aug 15. 22(11):1573-80. [QxMD MEDLINE Link].

19. Benito-Leon J, Louis ED, Bermejo-Pareja F. Elderly-onset essential tremor is associated with dementia. Neurology. 2006 May 23. 66(10):1500-5. [QxMD MEDLINE Link].

20. Klebe S, Stolze H, Grensing K, Volkmann J, Wenzelburger R, Deuschl G. Influence of alcohol on gait in patients with essential tremor. Neurology. 2005 Jul 12. 65(1):96-101. [QxMD MEDLINE Link].

21. Daniels C, Peller M, Wolff S, et al. Voxel-based morphometry shows no decreases in cerebellar gray matter volume in essential tremor. Neurology. 2006 Oct 24. 67(8):1452-6. [QxMD MEDLINE Link].

22. Ross GW, Dickson D, Cersosimo M. Pathological investigation of essential tremor. Neurology. Apr 2004. 62(7) S5:A537-A538.

23. Ma S, Davis TL, Blair MA, et al. Familial essential tremor with apparent autosomal dominant inheritance: should we also consider other inheritance modes?. Mov Disord. 2006 Sep. 21(9):1368-74. [QxMD MEDLINE Link].

24. Deng H, Le W, Jankovic J. Genetics of essential tremor. Brain. 2007 Jun. 130:1456-64. [QxMD MEDLINE Link].

25. Higgins JJ, Pho LT, Nee LE. A gene (ETM) for essential tremor maps to chromosome 2p22-p25. Mov Disord. 1997 Nov. 12(6):859-64. [QxMD MEDLINE Link].

26. Shatunov A, Sambuughin N, Jankovic J, et al. Genomewide scans in North American families reveal genetic linkage of essential tremor to a region on chromosome 6p23. Brain. 2006 Sep. 129:2318-31. [QxMD MEDLINE Link].

27. Higgins JJ, Lombardi RQ, Pucilowska J, Jankovic J, Tan EK, Rooney JP. A variant in the HS1-BP3 gene is associated with familial essential tremor. Neurology. 2005 Feb 8. 64(3):417-21. [QxMD MEDLINE Link].

28. Thier S, Lorenz D, Nothnagel M, et al. LINGO1 polymorphisms are associated with essential tremor in Europeans. Mov Disord. 2010 Apr 30. 25(6):717-23. [QxMD MEDLINE Link].

29. Clark LN, Park N, Kisselev S, Rios E, Lee JH, Louis ED. Replication of the LINGO1 gene association with essential tremor in a North American population. Eur J Hum Genet. 2010 Jul. 18(7):838-43. [QxMD MEDLINE Link]. [Full Text].

30. Tan EK, Teo YY, Prakash KM, et al. LINGO1 variant increases risk of familial essential tremor. Neurology. 2009 Oct 6. 73(14):1161-2. [QxMD MEDLINE Link]. [Full Text].

31. Louis ED et Al. Regional and Racial Differences in the Prevalence of Physician- Diagnosed Essential Tremor in the United States. Movement Disorders. 2003. Vol. 18, No. 9:pp. 1035–1040.

32. Song P, Zhang Y, ZHa M, Yang Q, Ye X, Yi Q, et al. The global prevalence of essential tremor, with emphasis on age and sex: A meta-analysis. J Glob Health. 2021. 11:04029:

33. Louis ED, Barnes LF, Ford B, Pullman SL, Yu Q. Ethnic differences in essential tremor. Arch Neurol. 2000 May. 57(5):723-7. [QxMD MEDLINE Link].

34. Tan EK, Lum SY, Prakash KM. Clinical features of childhood onset essential tremor. Eur J Neurol. 2006 Dec. 13(12):1302-5. [QxMD MEDLINE Link].

35. Louis ED, Dogu O. Does age of onset in essential tremor have a bimodal distribution? Data from a tertiary referral setting and a population-based study. Neuroepidemiology. 2007. 29(3-4):208-12. [QxMD MEDLINE Link].

36. Louis ED, Ottman R. Study of possible factors associated with age of onset in essential tremor. Mov Disord. 2006 Nov. 21(11):1980-6. [QxMD MEDLINE Link].

37. Louis ED, Benito-Leon J, Ottman R, Bermejo-Pareja F. A population-based study of mortality in essential tremor. Neurology. 2007 Nov 20. 69(21):1982-9. [QxMD MEDLINE Link].

38. Rajput A, Robinson CA, Rajput AH. Essential tremor course and disability: A clinicopathologic study of 20 cases. Neurology. 2004 Mar 23. 62(6):932-6. [QxMD MEDLINE Link].

39. Chatterjee A, Jurewicz EC, Applegate LM, Louis ED. Personality in essential tremor: further evidence of non-motor manifestations of the disease. J Neurol Neurosurg Psychiatry. 2004 Jul. 75(7):958-61. [QxMD MEDLINE Link].

40. Miller KM, Okun MS, Fernandez HF, Jacobson CE 4th, Rodriguez RL, Bowers D. Depression symptoms in movement disorders: comparing Parkinson's disease, dystonia, and essential tremor. Mov Disord. 2007 Apr 15. 22(5):666-72. [QxMD MEDLINE Link].

41. Benito-Leon J, Louis ED, Bermejo-Pareja F. Reported hearing impairment in essential tremor: a population-based case-control study. Neuroepidemiology. 2007. 29(3-4):213-7. [QxMD MEDLINE Link].

42. Ondo W, Jankovic J, Schwartz K, Almaguer M, Simpson RK. Unilateral thalamic deep brain stimulation for refractory essential tremor and Parkinson's disease tremor. Neurology. 1998 Oct. 51(4):1063-9. [QxMD MEDLINE Link].

43. Stolze H, Petersen G, Raethjen J, Wenzelburger R, Deuschl G. The gait disorder of advanced essential tremor. Brain. 2001 Nov. 124:2278-86. [QxMD MEDLINE Link].

44. Deeb J. Gannon K. Shah M, et al. Comparison of datscan imaging and smell testing in essential tremor and Parkinson disease. Jr Neurol, Neurosurg. & Psych. Sept 2007. 78(9):1018-1019.

45. Findley LJ, Shah M. Muhammed N, et al. Olfactory tests distinguish essential from parkinsonian tremor. Evidence of enhanced detection and age resistance in familial essential tremor. J Neurol Neurosurg Psych. Jan 2006. 77(1):140.

46. Robert A. Hauser, MD, Donald G. Grosset, MD. [123I]FP-CIT (DaTscan) SPECT Brain Imaging in Patients with Suspected Parkinsonian Syndromes. J Neuroimaging. 2012. 22:225-230.

47. Doep F. Plotkin M, Siegel L. Brain parenchyma sonography and 123I-FP-CIT SPECT in Parkinson’s disease and essential tremor. Mov. Disord. Dec 7 1007. 23(3):(405-410).

48. Stockner H, Sojer M, K KS, et al. Midbrain sonography in patients with essential tremor. Mov Disord. 2007 Feb 15. 22(3):414-7. [QxMD MEDLINE Link].

49. Luo WF, Zhang YC, Sheng YJ, Fang JC, Liu CF. Transcranial sonography on Parkinson's disease and essential tremor in a Chinese population. Neurol Sci. 2011 Dec 11. [QxMD MEDLINE Link].

50. Kim JS, Oh YS, Kim YI, Koo JS, Yang DW, Lee KS. Transcranial sonography (TCS) in Parkinson's disease (PD) and essential tremor (ET) in relation with putative premotor symptoms of PD. Arch Gerontol Geriatr. 2012 Jan 23. [QxMD MEDLINE Link].

51. di Biase L, Brittain JS, Shah SA, Pedrosa DJ, Cagnan H, Mathy A, et al. Tremor stability index: a new tool for differential diagnosis in tremor syndromes. Brain. 2017 Jul 1. 140 (7):1977-1986. [QxMD MEDLINE Link].

52. Koller WC, Vetere-Overfield B. Acute and chronic effects of propranolol and primidone in essential tremor. Neurology. 1989 Dec. 39(12):1587-8. [QxMD MEDLINE Link].

53. Winkler GF, Young RR. Efficacy of chronic propranolol therapy in action tremors of the familial, senile or essential varieties. N Engl J Med. 1974 May 2. 290(18):984-8. [QxMD MEDLINE Link].

54. Teräväinen H, Fogelholm R, Larsen A. Effect of propranolol on essential tremor. Neurology. 1976 Jan. 26(1):27-30. [QxMD MEDLINE Link].

55. Fytagoridis A, Sandvik U, Aström M, Bergenheim T, Blomstedt P. Long term follow-up of deep brain stimulation of the caudal zona incerta for essential tremor. J Neurol Neurosurg Psychiatry. 2011 Dec 28. [QxMD MEDLINE Link].

56. Benabid AL, Pollak P, Gao D, et al. Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders. J Neurosurg. 1996 Feb. 84(2):203-14. [QxMD MEDLINE Link].

57. [Guideline] Zesiewicz TA, Elble RJ, Louis ED, et al. Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology. 2011 Nov 8. 77(19):1752-5. [QxMD MEDLINE Link]. [Full Text].

58. O'Brien MD, Upton AR, Toseland PA. Benign familial tremor treated with primidone. Br Med J (Clin Res Ed). 1981 Jan 17. 282(6259):178-80. [QxMD MEDLINE Link]. [Full Text].

59. Ondo WG. Current and emerging treatments of essential tremor. Neurol Clin. 2020. 38(2):309-323.

60. Jeffrey, S. FDA Okays Brio Neurostimulation System for PD, ET. Medscape Medical News. Available at http://www.medscape.com/viewarticle/846456. June 12, 2015; Accessed: June 17, 2015.

61. Iorio-Morin C, Hodaie M, Lozano AM. Adoption of focused ultrasound thalamotomy for essential tremor: why so much fuss about FUS?. J Neurol Neurosurg Psychiatry. 2021. 92(5):549-554.

62. Wagle Shukla. Rationale and evidence for peripheral nerve stimulation for treating essential tremor. Tremor Other Hyperkinet Mov. 2022. 12(1):20.

63. Dogu O, Sevim S, Camdeviren H, et al. Prevalence of essential tremor: door-to-door neurologic exams in Mersin Province, Turkey. Neurology. 2003 Dec 23. 61(12):1804-6. [QxMD MEDLINE Link].

64. Thawani SP, Schupf N, Louis ED. Essential tremor is associated with dementia: prospective population-based study in New York. Neurology. 2009 Aug 25. 73(8):621-5. [QxMD MEDLINE Link]. [Full Text].

65. Elias WJ, Huss D, Voss T, Loomba J, Khaled M, Zadicario E, et al. A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med. 2013 Aug 15. 369(7):640-8. [QxMD MEDLINE Link].

66. Goldman MS, Ahlskog JE, Kelly PJ. The symptomatic and functional outcome of stereotactic thalamotomy for medically intractable essential tremor. J Neurosurg. 1992 Jun. 76(6):924-8. [QxMD MEDLINE Link].

67. Kondziolka D, Ong JG, Lee JY, Moore RY, Flickinger JC, Lunsford LD. Gamma Knife thalamotomy for essential tremor. J Neurosurg. 2008 Jan. 108(1):111-7. [QxMD MEDLINE Link].

68. Pahwa R, Lyons KL, Wilkinson SB, et al. Bilateral thalamic stimulation for the treatment of essential tremor. Neurology. 1999 Oct 22. 53(7):1447-50. [QxMD MEDLINE Link].

69. Schuurman PR, Bosch DA, Bossuyt PM, et al. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N Engl J Med. 2000 Feb 17. 342(7):461-8. [QxMD MEDLINE Link].

70. Taha JM, Janszen MA, Favre J. Thalamic deep brain stimulation for the treatment of head, voice, and bilateral limb tremor. J Neurosurg. 1999 Jul. 91(1):68-72. [QxMD MEDLINE Link].

71. Tasker RR. Deep brain stimulation is preferable to thalamotomy for tremor suppression. Surg Neurol. 1998 Feb. 49(2):145-53; discussion 153-4. [QxMD MEDLINE Link].

Natalya V Shneyder, MD Assistant Professor, Department of Neurology, Movement Disorders Center, University of South Florida Morsani College of Medicine; Attending Physician, Movement Disorders Specialist, Department of Neurology, James A Haley Veterans Hospital

Natalya V Shneyder, MD is a member of the following medical societies: American Academy of Neurology, Movement Disorder Society

Disclosure: Nothing to disclose.

Robert A Hauser, MD, MBA Professor of Neurology, Molecular Pharmacology and Physiology, Director, USF Parkinson's Disease and Movement Disorders Center, National Parkinson Foundation Center of Excellence, Byrd Institute, Clinical Chair, Signature Interdisciplinary Program in Neuroscience, University of South Florida College of Medicine

Robert A Hauser, MD, MBA is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Society of Neuroimaging, International Parkinson and Movement Disorder Society

Disclosure: Received consulting fee from Cerecor for consulting; Received consulting fee from L&M Healthcare for consulting; Received consulting fee from Cleveland Clinic for consulting; Received consulting fee from Heptares for consulting; Received consulting fee from Gerrson Lehrman Group for consulting; Received consulting fee from Indus for consulting; Received consulting fee from University of Houston for consulting; Received consulting fee from AbbVie for consulting; Received consulting fee from Adama.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida Morsani College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, American Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Bioserenity, Ceribell, Eisai, Jazz, LivaNova, Neurelis, Neuropace, SK life science, Sunovion, Takeda, UCB<br/>Serve(d) as a speaker or a member of a speakers bureau for: Aquestive, Bioserenity, Eisai, Jazz, LivaNova, Neurelis, SK life science, Stratus, Sunovion, UCB<br/>Received research grant from: Cerevel Therapeutics, Ovid Therapeutics, Neuropace, Greenwich Jazz, SK Life Science, Xenon Pharmaceuticals, UCB, Marinus, Neuroelectrics Corporation, Longboard, Janssen, Equilibre Biopharmaceuticals.

Deborah A Burke, MD Clinician, Sub-Investigator, USF Parkinson's Disease and Movement Disorders Center, University of South Florida Morsani College of Medicine; Investigator, Physician, Roskamp Institute Memory Clinic

Deborah A Burke, MD is a member of the following medical societies: American Academy of Neurology, International Parkinson and Movement Disorder Society

Disclosure: Nothing to disclose.

Theresa A McClain, RN, MSN, ARNP-BC Advanced Registered Nurse Practitioner and Investigator, Parkinson’s Disease and Movement Disorders Center, University of South Florida College of Medicine

Theresa A McClain, RN, MSN, ARNP-BC is a member of the following medical societies: Sigma Theta Tau International

Disclosure: Received consulting fee from Teva for consulting; Received consulting fee from Schering Plough for consulting; Received consulting fee from Biotie for consulting; Received consulting fee from Novartis for consulting.

Nestor Galvez-Jimenez, MD, MSc, MHA Chairman, Department of Neurology, Program Director, Movement Disorders, Department of Neurology, Division of Medicine, Cleveland Clinic Florida

Nestor Galvez-Jimenez, MD, MSc, MHA is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society

Disclosure: Nothing to disclose.

Daniel H Jacobs MD, FAAN, Associate Professor of Neurology, University of Florida College of Medicine; Director for Stroke Services, Orlando Regional Medical Center

Daniel H Jacobs is a member of the following medical societies: American Academy of Neurology, American Society of Neurorehabilitation, and Society for Neuroscience

Disclosure: Teva Pharmaceutical Grant/research funds Consulting; Biogen Idex Grant/research funds Independent contractor; Serono EMD Royalty Speaking and teaching; Pfizer Royalty Speaking and teaching; Berlex Royalty Speaking and teaching

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

• Print this section
• Print the entire contents of
• Print the entire contents of article