This patient has essential tremor involving the arms, head and voice.
About essential tremor
Essential tremor is a high-frequency rhythmic oscillation of the limb, head or voice that occurs while maintaining a posture, such as when the hands are outstretched. This type of tremor has many other names. When hereditary, it is called familial tremor. It is also called postural, senile and action tremor. Essential tremor is improved with alcohol and worse with anxiety, caffeine and lack of sleep.
Localization
The pathophysiologic mechanism of essential tremor is not known, though ablation or stimulation of thalamic nuclei can abolish the tremor in severe cases.