Essential Tremor

Have you noticed that your hands shake when you hold your silverware or pick up a glass of water? This is not uncommon. Shaking of the hands or other body parts can be due to consumption of caffeinated beverages, anxiety, or side effects to medications.

Sometimes tremors can be caused by more serious issues such as hyperthyroidism, seizures, and liver or kidney dysfunction.

Essential tremor, a neurological disorder, is the most common of all tremor disorders. According to the International Essential Tremor Foundation, it affects approximately 10 million people in the U.S. alone.

What is Essential Tremor (ET)?

An essential tremor is a nervous system disorder. It is usually not life-threatening or dangerous to one’s health.

People with ET have rhythmic shaking in parts of their body—usually in the hands.

Everyone has a slight tremor. But it usually isn’t noticed because it is so tiny. It is an essential tremor when it becomes obvious to the patient and others.

Most people can comfortably live their lives with ET. In more severe cases, it can be difficult for people to do everyday things by themselves, such as eat, dress, shave, or write.

These tremors only cause a disability if they advance and become severe. Contrary to popular belief, essential tremor is not a part of the natural aging process, but it is more common in people aged 40 or older.

What Causes Essential Tremor?

The actual cause of essential tremor is not known. But it is known that genetics can play a role. It is often passed down from parent to child.

Essential tremor is thought to be caused by unusual electrical brain activity that is processed through the thalamus. The thalamus is part of the cerebrum; it controls muscle activity and coordination.

Who is at Risk?

Essential tremor is usually seen in people over 65. However, this tremor can be seen at any age. Tremor that occurs at a young age may respond differently to treatment than with older adults.

Will it Go Away?

Essential tremor will not go away, but it can have an extremely slow progression. When symptoms remain minor, there is no need for treatment. When treatment is needed there are effective options.

Symptoms of Essential Tremor

People are often concerned that essential tremor is

  Parkinson’s disease. Seeing a neurologist will provide the proper diagnosis.

Symptoms of essential tremor include:

  • Involuntary and rhythmic shaking when one uses their hands

  • Tremor in hand(s), but it can occur in other parts of the body, including the tongue or head

  • Tremor in the voice

  • Uncontrolled nodding of the head

  • Tremors worsen with age

  • Tremors in the legs or feet, but this is rare

Other Facts about ET:

  • Tremors may lessen with a little alcohol consumption

  • It usually worsens with movement and is less noticeable when the body part is at rest

  • Tremor can spread to other parts of the body

  • It is rarely the same on both sides of the body

  • Caffeine and certain medications make symptoms worse

  • It can become disabling

Diagnosis of Essential Tremor

A comprehensive neurological examination will lead to an accurate diagnosis. We review medical and family history and evaluate symptoms.

No medical test definitively diagnoses essential tremor. It’s often more a case of ruling out other causes, such as thyroid disease, metabolic problems, or Parkinson’s Disease. A full neurological evaluation is done to check nervous system functioning. Tests evaluate reflexes, muscle strength, coordination, gait, and ability to feel certain sensations.

Other tests may be needed to rule out other medical conditions. Brain imaging or a dopamine transporter scan can help with diagnosis.

Treatments for Essential Tremor

The doctor will be able to determine which medication will work best for you to treat essential tremor. It can get better and improve with the right medication.

Things you can do to reduce essential tremor:

  • Avoid caffeine

  • Limit alcohol consumption

  • Avoid stress

  • Practice yoga and deep-breathing exercises

Are you concerned about your shaking hands? Are they causing difficulties or are you simply worried about what’s causing them to shake? Fortunately, most patient’s respond well to medications.



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