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Essential Tremor

Essential tremor is a neurological disorder that causes the hands, head, trunk, voice, or legs to shake rhythmically. It is often confused with Parkinson’s disease.

The cause of essential tremor is unknown, but for most people who have it, the condition seems to run in their family.

Facts about essential tremor

Essential tremor is the most common trembling disorder people experience.

In reality, everyone has some essential tremor, but the movements usually cannot be seen or felt. When they’re noticeable, the condition is classified as essential tremor disorder.

Essential tremor is most common among people older than 65, but it can affect people at any age. Although the cause isn’t known, one theory is that the cerebellum and certain other parts of the brain are not communicating correctly in people with essential tremor disorder. The cerebellum is a part of the brain that controls muscle coordination.

Types of essential tremor

There really is just one type of essential tremor, but it can occur in different people for different reasons:

  • Familial essential tremor. In most people, the condition seems to be passed down from a parent to a child.

  • Essential tremor related to another disorder. In some instances, a tremor is a symptom of another neurological disorder, such as Parkinson’s disease or dystonia. Sometimes essential tremor is mistaken for these other diseases when they are not present, so careful diagnosis by a doctor is important.

Symptoms

People with essential tremor will experience shaking and trembling at different times and in different situations, but some characteristics are common to all. Here is what you might typically experience:

  • Tremors occur when you move and are less noticeable when you rest.

  • Tremors get worse from certain medications, caffeine, or stress.

  • Tremors get worse as you age.

  • Tremors don’t affect both sides of the body in the same way.

Here are different signs of essential tremor:

  • Tremors that are most obvious in your hands

  • Difficulty performing tasks with your hands, such as writing or using tools

  • Shaking or quivering sound in your voice

  • Uncontrollable head-nodding

  • In rare instances, tremors in the legs or feet

Diagnosis

Your rapid, uncontrollable trembling, as well as questions about your medical and family history can help your doctor determine if you have familial essential tremor. He or she will probably need to rule out other conditions that could cause shaking or trembling. For example, tremors can be symptoms of diseases such as hyperthyroidism, so your doctor might test you for them, as well.

In some cases, the tremors might be related to other factors. To find out for certain, your doctor may have you try to:

  • Abstain from alcohol; if you’re an alcoholic, trembling is a common symptom.

  • Cut out cigarette smoking.

  • Avoid caffeine.

  • Avoid certain medications

Treatment

Propanolol and primidone are two medications often prescribed to treat essential tremor. Propanolol blocks the stimulating action of neurotransmitters to calm your trembling. Primidone is a common antiseizure medication that also controls the actions of neurotransmitters.

Gabapentin and topiramate are two other antiseizure medications that are sometimes prescribed. In some cases, tranquilizers like alprazolam or clonazepam might be suggested.

For essential tremor in the hands, Botox injections have shown some promise in easing the trembling. They work by weakening the surrounding muscles around the hands. For severe tremors, a stimulating device that gets implanted in the brain may help.

Prevention

Alcohol, cigarettes, caffeine, and stress all seem to make tremors worse. Abstaining from these substances or stressful activities as much as possible can help. Some drugs can also contribute to trembling, so you’ll want to ask your doctor if any of your medications might be playing a role.

Managing essential tremor

Essential tremor is usually not dangerous, but it can certainly be frustrating for the people who have to deal with it. Talk with your doctor about other options, such as surgery, if it starts to affect your quality of life.

Home remedies

Your best strategy for managing essential tremor at home is to avoid potential contributors, such as caffeine, nicotine, and alcohol. Because stress plays a role, some do-it-yourself stress relaxation techniques, such as yoga or deep breathing exercises, can be helpful.

Online Medical Reviewer: Sohrabi, Farrokh, MD
Online Medical Reviewer: Ziegler, Olivia Walton, MS, PA-C
Date Last Reviewed: 6/24/2012
© 2000-2014 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.