Essential tremor (ET) is a neurological disorder that causes your hands, head, trunk, voice, or legs to shake rhythmically. It is often confused with Parkinson disease.
ET is the most common trembling disorder that people have. Everyone has some ET, but the movements usually cannot be seen or felt. When tremors are noticeable, the condition is classified as ET.
ET is most common among people older than age 65, but it can affect people at any age.
ET can occur in different people for different reasons:
Essential tremor related to another disorder. Sometimes, a tremor is a symptom of another neurological disorder, such as Parkinson disease or dystonia. Sometimes, ET is mistaken for these other diseases when they are not present. A healthcare provider’s careful diagnosis is extremely important.
The cause of ET isn’t known. However, one theory suggests that your cerebellum and other parts of your brain are not communicating correctly. The cerebellum is a part of the brain that controls muscle coordination.
If you have ET, you will have shaking and trembling at different times and in different situations, but some characteristics are common to all. Here is what you might typically experience:
Here are different signs of essential tremor:
Your rapid, uncontrollable trembling, as well as questions about your medical and family history, can help your healthcare provider determine if you have familial ET. He or she will probably need to rule out other conditions that could cause shaking or trembling. For example, tremors could be symptoms of diseases, such as hyperthyroidism. Your healthcare provider might test you for those, as well.
In some cases, the tremors might be related to other factors. To find out for certain, your healthcare provider may have you try to:
Propanolol and primidone are 2 medicines often prescribed to treat ET. Propanolol blocks the stimulating action of neurotransmitters to calm your trembling. Primidone is a common antiseizure medicine that also controls the actions of neurotransmitters.
Gabapentin and topiramate are 2 other antiseizure medicines that are sometimes prescribed. In some cases, tranquilizers like alprazolam or clonazepam might be suggested.
For ET in your hands, botulinum toxin (Botox) injections have shown some promise in easing the trembling. They work by weakening the surrounding muscles around your hands. For severe tremors, a stimulating device (deep brain stimulator) surgically implanted in your brain may help.
The specific cause of ET is not known, so scientists are not sure how the condition can be prevented.
ET is usually not dangerous, but it can certainly be frustrating if you have to deal with it. Certain factors can make tremors worse, so the following steps may help to decrease tremors:
Talk with your healthcare provider about other options, such as surgery, if ET starts to affect your quality of life.
If you have been diagnosed with ET, talk with your healthcare provider about when you might need to call. He or she will likely advise you to call if your tremors become worse, or if you develop new neurologic symptoms, such as numbness or weakness.
Tips to help you get the most from a visit to your healthcare provider:
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