Neuropsychiatric Disease and Treatment Open Access Full Text Article Overview of essential tremor Dovepress open access to scientific and medical research R e v i e w Theresa A Zesiewicz Abinaya Chari i srat Jahan Amber M Miller Kelly L Sullivan Department of Neurology, Parkinson Research Foundation, James A. Haley v eterans Administration Hospital, University of South Florida, Tampa, FL, USA Correspondence:Theresa A Zesiewicz Department of Neurology, University of South Florida, 12901 Bruce B Downs Boulevard,Tampa, FL 33612, USA Tel 813-974-5909 Fax 813-974-8032 email tzesiewi@health.usf.edu Abstract: Essential tremor (ET) is one of the most common movement disorders in the world. Despite this, only one medication (propranolol) is approved by the Food and Drug Administra- tion (FDA) to treat it. Fortunately, recent studies have identified some additional medications as treatment of ET. Surgical procedures, such as deep brain stimulation of the ventral intermediate nucleus of the thalamus, offer treatment for refractory tremor. The epidemiology, pathogenesis, and medical and surgical treatment of ET will be discussed in this paper. Keywords: Essential tremor, diagnosis, treatment, pathogenesis Introduction Essential tremor (ET) is one of the most common tremor disorders in the world, and is characterized by a postural and/or kinetic tremor. While the disease is often called “benign”, it frequently causes difficulty with everyday tasks such as writing, pour- ing, and eating. Despite its high prevalence, only one medication (propranolol) is currently approved by the United States Food and Drug Administration (FDA) for its treatment.1 The last decade has witnessed advances in ET, including the finding that “nonmotor symptoms”, including mood and cognitive dysfunction, appear to occur more commonly in ET patients than in normal controls.2,3 Additional medications to primidone and propranolol have been identified that may effectively reduce tremor. This review will focus on the epidemiology, pathogenesis, and current medical and surgical therapy of ET. Epidemiology ET is more prevalent than Parkinson’s disease (PD) or Alzheimer disease (AD), and there is no world population that is immune to its development.4 The age- and gender-adjusted prevalence of ET is estimated to be 3 to 4 per 1000, with an annual incidence of 23.7 per 100,000.5 The incidence of ET rises with increasing age,4 although the disease can also affect children.6 Approximately 4% of adults 40 years of age and older are affected by ET. A family history of ET appears to correlate with younger reported age of tremor onset.7 While there is no conclusive evidence that ET increases an individual’s risk of mortality, one longitudinal prospective study found a small increased risk of death in ET patients.8 However, further research is needed to corroborate this finding. While ET has been thought to have a bimodal age of onset (young adulthood and middle age),9 one study of ET epidemiology that took place in both a population-based submit your manuscript | www.dovepress.com Dovepress 4795 Neuropsychiatric Disease and Treatment 2010:6 401–408 401 © 2010 Zesiewicz et al, publisher and licensee Dove Medical Press Ltd.This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.