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Yashoda Hospitals > Diseases & Treatments > Neurology & Neurosurgery > Essential tremor

Essential tremor

Causes, Symptoms, Treatment Options

What is an essential tremor?

Essential tremor (ET) is the most common movement disorder. It is also known as benign essential tremor, familial tremor, or hereditary tremor. Patients with ET may experience uncontrollable shaking (tremor) in the hands, head, voice, or other body parts. The condition usually begins as an adult and may gradually become worse with age. Tremor is typically most noticeable when holding the hands outstretched or making fine hand movements, such as holding a cup, using a spoon, or writing. The tremor usually stops if the hands/arms are completely relaxed, such as when resting in the lap. Stress often makes the tremor worse.

Essential tremor

What are the causes of essential tremors?

The cause of ET is unknown, but more than half of patients have another family member with tremor. Researchers have not found the gene(s) that cause ET. For patients with a family history of ET, symptoms tend to begin at an earlier age. Research suggests that ET develops in the brain, but patients’ brain scans appear normal. There is no diagnostic test for ET. However, your doctor may test your blood for other conditions, such as thyroid disease, that could worsen the tremor. Some medications may also worsen tremor.

What are the symptoms of essential tremor?

The symptoms of essential tremor are

  • Involuntary shaking of the hands, head, legs, voice, or jaw (tremor).
  • The tremor happens when you are holding your hands out or trying to do something (writing or drinking tea) and goes away when you are resting.
  • The tremor may start in one hand and then spread to the other.
  • If you have other symptoms in addition to tremor, you may have a different condition.

What is the treatment for essential tremor?

  • There is effective treatment to lessen the tremor, but there is no cure. Medications are usually given on a trial-and-error basis. Some work better than others depending on the individual patient. Medications for ET include:
  • Beta-blockers, such as propranolol
  • Anti-seizure medications, such as primidone, gabapentin, topiramate, and clonazepam
    Patients with certain types of tremor may benefit from botulinum toxin injections.
  • Botox injections can be given by injection into the muscles that shake. Botox can help to reduce the tremor for certain people and is best for tremors in the head and neck.
  • Cutting back on caffeine, other stimulants, and some tremor-producing medications.
  • Although medical treatment may help some patients with tremor and should be tried first, those with severe tremor may consider a surgical procedure.

There is more than one type of surgery for ET; they are:

Deep Brain Stimulation (DBS): This type of surgical intervention has proven effective. another is another type of thalamus surgery where a thin wire (also called an electrode) is placed into the thalamus and connected to a pacemaker-like device under the skin in the chest.

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FAQ's

    The exact cause of essential tremor is unknown, but we do know that it runs in families and gets worse with age. It also becomes worse with stress, a lack of sleep and caffeine.

    An experienced movement disorder specialist can efficiently diagnose essential tremor by clinical examination, history taking about family, past illness, and use of any medications. A few blood tests may be suggested to ruleout other conditions and confirm the diagnosis.

    Essential tremor can’t be cured but there are treatments available that can reduce the tremor if it is affecting your life. Like medications and Botox injections. In a few cases where medications do not achieve a successful reduction in the symptoms, a surgical intervention like deep brain stimulation may be suggested.

    ET does not shorten the life span. Tremor may increase over time, but the change is usually slow, typically over many years. Eventually some patients may experience a degree of disability, such as difficulty writing, eating, and drinking, or even social embarrassment. Mild tremor does not typically require treatment, and early treatment does not stop or slow the symptoms. Treatment is seriously sought only when the tremor affects daily activities and increases dependency.