Essential Tremor

Essential tremor (ET), recognized as the most common movement disorder, silently permeates through populations, often with patients oblivious to their diagnosis due to its mildness or misattribution to alternative diagnoses. The chapter reviews the multifaceted nature of ET, characterized by its classic depiction of action tremor of the hands and possible head or voice tremor, against a backdrop of various symptom presentations and severities, even within families. Navigating the diagnostic pathway requires thorough and careful clinical evaluation, distinguishing ET from its mimics. Controversy shrouds the definition of ET, especially pertaining to the incorporation of isolated tremor variants, illustrating the heterogeneous phenotypes of ET. Management includes decisions on the initiation and modality of treatment, including oral medications, botulinum toxin injections, and advanced therapeutic interventions such as deep brain stimulation or high intensity focused ultrasound.