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Differentiating Parkinson disease and essential tremor

Differentiating Parkinson disease and essential tremor
Clinical features Parkinson disease tremor Essential tremor
Age at onset >50 years Bimodal 2nd and 6th decade
Sex Male ≥ Female Male = Female
Family history ~10 to 15 percent ~50 percent
Asymmetry +++ +
Frequency 4 to 6 Hz 6 to 12 Hz
Character At rest Postural, kinetic
Supination-pronation Flexion-extension
Distribution Hands, legs, chin, tongue Hands, head, voice
Associated features Bradykinesia, rigidity, postural instability, micrographia Mild gait disorder or cerebellar signs in a minority
Modified with permission from: Jankovic J. Essential tremor: Clinical characteristics. Neurology 2000; 54(11 Suppl 4):S21. Copyright © 2000 Lippincott Williams & Wilkins.
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