A 60-year-old woman presents with a tremor

A 60-year-old woman presents with a tremor. Which one of the following features would suggest a diagnosis of essential tremor rather than Parkinson’s disease?

Difficulty in initiating movement
Tremor is worse following alcohol
Postural instability
Unilateral symptoms
Tremor is worse when the arms are outstretched

Dr. Kasper:
Tremor is worse when the arms are outstretched

Difficulty in initiating movement (bradykinesia), postural instability and unilateral symptoms (initially) are typical of Parkinson’s. Essential tremor symptoms are usually eased by alcohol.