Essential tremor (ET) 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. It is not a life-threatening disease, but it can be a life-altering condition. People with essential tremor often lose the ability to perform simple tasks like driving or going to work. Coping with the resulting feelings of isolation can be difficult. Among more than 20 different kinds of tremor, essential tremor is the most common. As many as one in 20 people older than age 40 and one in five people over 65 may have essential tremor. Although the average age of onset for essential tremor is 40, ET may first appear at any age between childhood and old 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
The two types of tremor include:
- action tremor - a voluntary movement such as lifting a cup to one's mouth
- postural tremor - a voluntary holding of a position against gravity such as reaching or extending one's hand or arm
Most people with essential tremor experience both postural and action tremor
Essential tremor 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 of Essential Tremor
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 of Essential Tremor
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 of Essential Tremor
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 of Essential Tremor
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.