Patient case (clinical description): A 60-year-old man comes to the clinic complaining of hand tremor that started few months ago.  It is most bothering when he wants to drink from a glass or pour from a bottle. He does not smoke, but drinks occasionally. He recently started consuming more alcohol as his tremor subsides somewhat when he drinks small amounts of alcohol.  Family history is significant for similar problems in his mother.  Vital signs are normal and the patient has no other medical conditions.  Neurologic examination shows bilateral tremor in the upper extremities. The diagnosis of essential tremor is confirmed.

Patient's own account: I'm only a 60 years old man but I already suffer from shaky hands. It started a few months ago, and it really bothers me when I want to pour myself a glass or even while drinking. I don't smoke, but I drink alcohol from time to time. To be honest, I've been drinking a little more lately since it helps me with the shaking. My mom had the same issue when she was my age. The doctor took my vitals, and they were normal. I don't have any other medical issues. I underwent neurological exams and it showed that I’m shaky from both sides. The doctor diagnosed me with essential tremor.

Clinical trial: Pre-lemniscal Radiation Deep Brain Stimulation for ET

Eligibility criteria:
Inclusion Criteria:

          1. diagnosis of essential tremor based on clinical criteria established by the Essential
             Tremor Consortium

          2. Moderate or severe axial-dominant (head/neck/voice) tremor (Tremor Rating Scale [TRS]
             face, tongue, voice, head or trunk tremor score of 2 or above)

          3. May have bilateral appendicular tremor

          4. Tremor refractory to at least two medications, including primidone and propranolol

          5. Age between 21 and 75

          6. Male or Female

          7. Significant disability due to essential tremor despite medical treatment (TRS score of
             2 or above in any one of the items 16-23 [speaking, feeding other than liquids,
             bringing liquids to mouth, hygiene, dressing, writing, working, and social
             activities])

        Exclusion Criteria:

          1. Tremor due to other etiologies

          2. Pregnancy

          3. Presence of any other neurodegenerative disease

          4. Presence of significant cognitive impairment

          5. Presence of any medical condition that precludes neurological surgery

          6. Patients with another implanted stimulator or metallic implant, e.g. cochlear implant,
             cardiac pacemaker, spinal cord stimulator, aneurysm clips

          7. Patients who have a known need for future MRIs using a full body radio-frequency (RF)
             coil or a head transmit coil that extends over the chest area or that do not comply
             with Medtronic's "MRI Guidelines for Medtronic Deep Brain Simulation Systems"

          8. Patients with a history of seizures

          9. Patients with psychiatric illness that are not well controlled

         10. Patients with risk factors for intraoperative or postoperative bleeding (platelet
             count less than 125,000 per cubic millimeter, PT and PTT not within normal limits)

         11. Patients with brain tumors
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 21 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Entailment