title: The differential diagnosis and treatment of tremor.
abstract: BACKGROUND
  Essential tremor is the most common type of tremor, with a prevalence of 0.4% in the overall population and 4-7% in persons over age 65. In general, tremor is so common that patients with tremor are frequently treated not only by neurologists, but also by physicians from other specialties.
  
  
  METHODS
  This review is based on publications retrieved by a selective PubMed search and on guidelines from Germany and abroad.
  
  
  RESULTS
  Particular tremor syndromes are usually diagnosed on the basis of their typical clinical presentation and whatever accompanying manifestations may be present. Ancillary tests are usually unnecessary. Unilateral rest tremor accompanied by rigidity and bradykinesia is typical of Parkinson's disease. Essential tremor is a bilateral postural tremor. The most common cause of intention tremor is multiple sclerosis. Mild tremor syndromes can often be treated satisfactorily with drugs. In case of severe tremor, which is rarer, a stereotactic operation can be considered. The usual outcome of such procedures is the complete suppression of tremor.
  
  
  CONCLUSIONS
  Most patients with tremor can be given a precise diagnosis and offered specific treatment. It is important for the physician to inform the patient about the expected course of tremor over time, its possible genetic causes, and the various available treatments.
authors.affiliation: Department of Neurology, Institute for Clinical Neurosciences, Ludwig-Maximilians University of Munich, Klinikum Großhadern, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Department of Neurosurgery, German Center for Neurodegenerative Diseases, Tübingen University.
authors.forename: Kai
authors.initials: K
authors.lastname: Bötzel
authors.forename: Volker
authors.initials: V
authors.lastname: Tronnier
authors.forename: Thomas
authors.initials: T
authors.lastname: Gasser
mesh_terms: D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D003937:Diagnosis, Differential; D006801:Humans; D009069:Movement Disorders / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D014202:Tremor / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*
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