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Table 1.  

Cognitive Deficits Associated with Essential Tremor34

Box 1.  

Classic Concept of Essential Tremor

Box 2.  

Essential Tremor: New Findings

Box 3.  

Cognition in Patients with Essential Tremor


Essential Tremor -- A Neurodegenerative Disorder Associated With Cognitive Defects?

  • Authors: Félix Bermejo-Pareja, MD, PhD
  • CME Released: 4/12/2011
  • Valid for credit through: 4/12/2012
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Target Audience and Goal Statement

This activity is intended for primary care clinicians, family practitioners, and other health professionals caring for patients with benign essential tremor.

The goal of this activity is to review the evidence that essential tremor may be a slowly progressive neurodegenerative disorder.

Upon completion of this activity, participants will be able to:

  1. Describe cognitive and mood abnormalities in patients with essential tremor on the basis of review findings
  2. Describe evidence for cerebellar and other pathology in patients with essential tremor on the basis of review findings
  3. Describe recommended diagnostic workup in patients with essential tremor on the basis of review findings


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  • Félix Bermejo-Pareja, MD, PhD

    Department of Neurology, University Hospital "Doce de Octubre," Madrid, Spain


    Disclosure: Félix Bermejo-Pareja, MD, PhD, has disclosed no relevant financial relationships.


  • Heather Wood

    Chief Editor, Nature Reviews Neurology


    Disclosure: Heather Wood has disclosed no relevant financial relationships.

CME Author(s)

  • Laurie Barclay, MD

    Freelance writer and reviewer, Medscape, LLC


    Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

CME Reviewer(s)

  • Nafeez Zawahir, MD

    CME Clinical Director, Medscape, LLC


    Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

  • Sarah Fleischman

    CME Program Manager, Medscape, LLC


    Disclosure: Sarah Fleischman has disclosed no relevant financial relationships.

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    For Physicians

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Essential Tremor -- A Neurodegenerative Disorder Associated With Cognitive Defects?: Symptoms of Essential Tremor


Symptoms of Essential Tremor

Essential tremor is characterized by a positional and/or volitional 4-12 Hz tremor that can affect all body parts. This disorder most often affects the arms—90-95% of patients with essential tremor have tremor in the arms and hands—but can also affect the head (30% of cases), voice (20%) and legs (10-15%). The trunk is infrequently affected (5% of cases). Essential tremor often has a bilateral presentation but can also be asymmetric in nature,[1-9,48-50] and is rarely seen at rest. The tremor is exaggerated under stressful conditions, and in 50-70% of cases can be ameliorated by consuming alcohol.[1-6] Gait ataxia is typically observed in 50% of patients with essential tremor, and is especially prevalent in those individuals who have had the disease for a long time, or in severe cases.[10] Essential tremor never spontaneously goes into remission; in fact, although long periods of stability are possible, the severity of this disorder always increases and affects more body parts over time. These changes in disease severity are most prominent in elderly patients.[1-6]