Is Essential Tremor Symmetric?

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Abstract
ESSENTIAL TREMOR (ET) is one of the most common neurologic disorders.1 Published statements2-14 differ regarding the asymmetry of arm tremor, providing the reader with a confusing set of contradictory statements. Some studies7-9 have suggested that asymmetry is uncommon, while others3-6 have suggested that it may be common. Many others1,10-14 have not commented. In fact, the prevalence of asymmetry and the magnitude of asymmetry of arm tremor have been the focus of little systematic investigation. The importance of such an investigation is that it might provide additional insight into the underlying physiological features of ET, a disorder with as yet no consistently identified pathological changes at autopsy.2 In this study, using data from a large population-based study examining the prevalence, clinical features, and the familial aggregation of ET, we examined the issue of whether ET is symmetrical. The specific aims of this study are (1) to estimate the prevalence of asymmetry of arm tremor in ET and (2) to quantify the magnitude of asymmetry of arm tremor using clinical and neurophysiological measures.

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