Essential tremor: Causes, symptoms, diagnosis and treatment
A person with essential tremor (ET) experiences uncontrollable shaking, trembling or tremors in parts of the body.
Essential tremor is a nerve disorder affecting around 4% of people over 40.
The symptoms of essential tremor often affect arms and hands, but can affect other areas such as the feet, head, face, jaw, tongue and voice.
Tremors may be classed as mild, moderate, or severe.
The condition can be a nuisance to start with, but can worsen to affect daily life such as writing, shaving, or putting on makeup.
Essential tremor cannot be cured but medication may help relieve symptoms.
What causes essential tremor?
In around half of all essential tremor cases, an inherited gene mutation affecting the cerebellum and inferior olive parts of the brain is thought to be responsible.
If a parent has essential tremor, their child has around a 50% chance of inheriting the gene and developing the condition later in life.
Before diagnosing essential tremor, doctors may need to eliminate other causes of tremors, including Parkinson's disease, MS, and overactive thyroid (hyperthyroidism).
What are the symptoms of essential tremor?
The main symptoms associated with essential tremor include:
- Uncontrollable shaking that occurs for brief periods of time
- Shaking voice
- Nodding head
- Tremors that worsen during periods of emotional stress
- Tremors that get worse with purposeful movement
- Tremors that lessen with rest
- Balance problems in rare cases
How is essential tremor treated?
Mild essential tremor may not require treatment. Avoiding tremor triggers may help, including caffeine, lack of sleep and stress.
For moderate essential tremor, drugs such as propranolol (beta blocker) and primidone (anticonvulsant) can help relieve symptoms for more than half of all patients.
If those treatments haven’t worked sedatives may be prescribed.
In rare cases, another approach is a botulinum toxin (Botox) injection into an affected muscle.
Treatment for severe tremor includes deep brain stimulation and an operation on the thalamus area of the brain called a thalamotomy.
Can essential tremor be prevented?
Because the exact cause of essential tremor is unknown, there is currently no way to prevent it.