Inclusion Criteria:  All adults Patients are fulfilling cases definition of essential tremors will be included. Gender: both sexes are included. Any patient is, able to provide informed consent including permission to obtain information from patients' clinical medical history of at least three years' duration  Exclusion Criteria:  Patients are diagnosed with other neurological disorders unrelated to essential tremors. Patients had any other condition presented with other cognitive or psychiatric disorders or known as drug abusers. Patient had any systemic disease presented with tremors rather than essential tremors or compliant on medication had tremors side effect.