Essential tremor is diagnosed clinically, from a tremor that appears during action rather than at rest, usually affecting both hands, often with a family history, and without the slowness or rigidity that would suggest Parkinson's disease. No test confirms it.
Essential tremor is diagnosed clinically, from a tremor that appears during action rather than at rest, usually affecting both hands, often with a family history, and without the slowness or rigidity that would suggest Parkinson's disease. No test confirms it.
This is the distinction that matters most and the one most often confused. Essential tremor appears during action: holding a cup, writing, bringing a spoon to the mouth. Parkinson's tremor is typically present at rest, when the hand is supported and relaxed, and diminishes with purposeful movement. Essential tremor usually affects both hands roughly equally; Parkinson's typically begins on one side. Essential tremor is not accompanied by the slowness and rigidity that define Parkinson's disease.
A family history is common, since essential tremor frequently runs in families. Many people report that a small amount of alcohol temporarily reduces the tremor, which is characteristic and worth mentioning even though it feels like an odd thing to raise. The head and voice may be involved, producing a nodding tremor or a quavering voice, which does not occur in the same way in Parkinson's disease. Onset can be at any age and it typically progresses slowly over years.
An overactive thyroid causes tremor and is easily checked. So do a number of common medications and substances, including some asthma inhalers, certain antidepressants, lithium, and simply too much caffeine. Excessive alcohol and alcohol withdrawal both produce tremor. Because there is no confirmatory test, the diagnosis rests on the examination and on a careful medication and substance history, which is why bringing a complete list matters more than it might seem.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: National Institute of Neurological Disorders and Stroke; MedlinePlus: Parkinson's disease; MedlinePlus, National Library of Medicine.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.