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Essential Tremor

Essential Tremor Overview

Essential tremor is a neurological disease that causes uncontrollable shaking, usually in the hands. Symptoms occur gradually and can get worse with time. Essential tremor is typically not a dangerous condition, but symptoms can become severe in some people and make it difficult to perform daily tasks.

Essential tremor usually follows a progressive course, meaning that symptoms get worse as time goes on.

Essential Tremor Symptoms

Symptoms of essential tremor include rhythmic shaking, usually in your hands, which gets worse with voluntary movement. Symptoms may be progressive. Emotional stress, caffeine intake, certain medications, physical exhaustion, low blood sugar, and temperature may aggravate symptoms.

Differences Between Essential Tremor and Parkinson’s Disease

Essential tremor is often confused with Parkinson’s disease, but there are a few key differences between the two:

  • Essential tremor can affect your head, hands, or voice. While Parkinson’s disease can cause softening of the voice and reduced facial expression, it typically does not cause tremor of your head or voice.
  • Parkinson’s disease usually causes symptoms like a shuffling walk and stooped posture. Symptoms of essential tremor are typically confined to parts of the body affected and do not usually impair your gait or posture.
  • Essential tremor symptoms get worse with voluntary movement, whereas Parkinson’s disease tremors become more intense when you’re resting.

If you are experiencing any symptoms, contact a medical professional.

Essential Tremor Treatments

If your symptoms are mild, you may not need essential tremor treatment. However, if your tremors are affecting your ability to perform daily activities, you may want to discuss treatment options with your doctor.

Medication and Physical Therapy for Essential Tremor

Your doctor may recommend medications to relieve your tremors, such as beta blockers, anti-seizure drugs, or tranquilizers. Physical therapy may help improve your muscle control and coordination, and occupational therapy may help you adapt to living with essential tremor.

Deep Brain Stimulation (DBS) for Essential Tremor

If your symptoms are severe and you are not responding to medications, your doctor may recommend deep brain stimulation (DBS). In deep brain stimulation, a surgically implanted device called a neurostimulator delivers small electrical pulses to the thalamus to interrupt signals that may be causing your tremors.

Focused Ultrasound for Essential Tremor

Focused ultrasound thalamotomy is another option for the treatment of essential tremor. It is a minimally invasive procedure that uses sound waves to deactivate a small part of the thalamus, which is the part of the brain where essential tremor arises.

Video: Focused Ultrasound for Essential Tremor

Additional Information

How common is essential tremor?

Essential tremor is the most common type of tremor and the most common movement disorder. It is as much as 20 times more prevalent than Parkinson’s disease.

Who gets essential tremor?

Essential tremor most often occurs in men and women over age 40, but it can occur at any age.

Essential tremor may be inherited, but this mechanism only accounts for about half of cases. The cause in other cases is unknown. However, the thalamus, a structure deep within the brain, is thought to be involved.

How is essential tremor diagnosed?

Your doctor may ask about you and your family’s medical history, conduct a physical and neurological examination, and order imaging and laboratory tests to rule out other conditions. There is no definitive test for diagnosing essential tremor. Rather, the diagnosis is obtained by ruling out other conditions that have similar symptoms.

Patient Resources

International Essential Tremor Foundation

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Essential tremor is as much as 20 times more prevalent than Parkinson’s disease.
Medically Reviewed by Holly Shill, MD, FAAN on March 31, 2021