A 62-year-old man comes to the physician because of tremors in both hands for the past few months. He has had difficulty buttoning his shirts and holding a cup of coffee without spilling its content. A couple of weeks ago, he has noticed that his symptoms improved after drinking a glass of whiskey. Family history is significant for similar problems in her mother. Vital signs are normal. Neurologic examination shows bilateral tremor in the upper extremities. Which of the following is the best treatment for this patient?

Question

A 62-year-old man comes to the physician because of tremors in both hands for the past few months. He has had difficulty buttoning his shirts and holding a cup of coffee without spilling its content. A couple of weeks ago, he has noticed that his symptoms improved after drinking a glass of whiskey.   Family history is significant for similar problems in her mother.  Vital signs are normal.  Neurologic examination shows bilateral tremor in the upper extremities.  Which of the following is the best treatment for this patient?

Quizplus · Accepted Answer

Eductional Objective: Essential tremor is the most common movement disorder.  This patient has a bilateral low-amplitude tremor that worsens with purposeful voluntary movement (e.g., finger-to-nose test). Improvement with alcohol and a family history of similar symptoms makes essential tremor the most likely diagnosis.  First-line treatment is propranolol.

A 62-Year-Old Man Comes to the Physician Because of Tremors