Which statement best describes essential tremor criteria?

• A. Isolated bilateral upper limb action tremor lasting at least three years
• B. Tremor with parkinsonian features
• C. Tremor in infancy
• D. Tremor at rest

Answer: (B)

Essential tremor is best characterized by an action (postural/kinetic) tremor that involves both hands/arms in a bilateral, isolated pattern, usually without rest tremor or other neurological signs. This reflects the core feature that the tremor emerges with voluntary movement and sustained posture rather than at rest, and it tends to persist and be progressive over time. The option describing an isolated bilateral upper limb postural/kinetic tremor lasting for years fits these criteria, since it emphasizes tremor during movement, bilateral involvement, and a chronic course, which are hallmarks of essential tremor.

Tremor with parkinsonian features would point toward Parkinson disease or a parkinsonian syndrome, which includes resting tremor plus bradykinesia and rigidity rather than the action tremor pattern of essential tremor. Tremor in infancy is not typical for essential tremor, which usually presents in adulthood. Tremor at rest is the defining feature of rest tremor and is not characteristic of essential tremor, which is specifically an action tremor.