Essential tremor

Essential tremor leads to uncontrollable, rhythmic shaking during active movement or while holding a fixed pose or posture. Tremors may be mild at first but typically get worse over time. This makes daily tasks such as writing, eating, drinking, dressing, shaving and using tools difficult.

When it affects the head, neck or vocal chords, essential tremor may lead to uncontrollable nodding of the head and trembling of the voice when speaking.

The exact cause of essential tremor is not known. In 50% to 70% of cases, though, there is a family history of essential tremor (familial tremor). Individuals with familial tremor typically display symptoms early in life.

An estimated 7 million people in the United States have essential tremor. Essential tremor can happen at any age.

Certain activities and conditions may make symptoms worse. These include:

• caffeine intake
• certain medications
• emotional stress
• low blood sugar
• physical exhaustion
• temperature extremes

At Allina Health, our movement disorder specialists will perform a neurological examination to determine whether you have essential tremor or whether your tremor is related to another condition.

They make look to see whether your tremors:

• occur during active movement
• affect both upper extremities
• occur in the absence of other neurological symptoms.

There is no cure for essential tremor, but there are treatments that can help improve symptoms. An Allina Health neurologist will evaluate your condition to determine the most appropriate option:

• Occupational or physical therapy through the Courage Kenny Rehabilitation Institute (CKRI), part of Allina Health. CKRI offers comprehensive rehabilitation services and expert treatment to help patients improve function, gain greater independence and meet their individual goals.
• Medication can be used to decrease the tremor and make activities easier.  There are options that can be taken as needed or regularly every day. The two most common medications used to treat tremor are propranolol and primidone.
• Deep brain stimulation surgery at Abbott Northwestern Hospital is an FDA-approved treatment that can effectively treat many of the debilitating symptoms caused by difficult-to-treat Parkinson’s disease, essential tremor and dystonia.
• Focused ultrasound is an incision-free treatment for patients with essential tremor or tremor predominant Parkinson’s disease who have not responded well to medications. It uses sound waves guided by MRI to treat a small spot deep in the brain considered to be responsible for tremor.

Although there may be similarities in symptoms, essential tremor is not tremor-dominant Parkinson’s disease. Key differences include:

• Essential tremor usually occurs in motion, whereas tremors related to Parkinson’s disease are more noticeable when at rest.
• While Parkinson’s disease, like essential tremor, may affect the hands, and though it may lead to softening of the voice, it does not typically cause trembling of the head and voice.
• Parkinson’s disease may cause a stooped posture and a shuffling walk, while essential tremor is usually restricted just to the affected body parts.