Essential Tremor

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Abstract
This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.A 66-year-old woman presents with tremor of the hands. She first noticed a mild tremor six years earlier, but the tremor has been worsening for the past two years. It occurs when she is using her hands, interfering with some activities of daily living. For example, she can no longer eat soup without spilling, put in her contact lenses, or apply lipstick. A writer, she is no longer able to write in longhand or type her manuscripts and must dictate them. The tremor causes a great deal of embarrassment in social situations. How should this patient be evaluated and . . .