What Are Essential Tremors?

Essential tremors or ET are a neurological disorder marked by the involuntary shaking of a body part or parts. This shaking is rhythmic and visible to others. Essential tremors are most common in the hands but can also affect the head, voice, legs, and trunk. Persons age 40 and older are most likely to develop this condition, which medical science views as distinct from Parkinson’s disease. In some, the tremors start mild and remain that way; in others, they become more pronounced and spread to other regions of the body. If you or a loved one is developing a visible tremor, contact your Baptist Health medical provider for diagnosis and treatment options. 

What Are the Symptoms of Essential Tremors?

Essential tremors are distinguished by:

• A gradual beginning and slow development
• Appearing first in the hands
• Affecting one rather than both sides of the body
• Being more prominent in movement than at rest
• Becoming worse under the influence of fatigue, stress, caffeine, and low blood-sugar (hypoglycemia).

Tremors come in several types, including intentional, postural, task-specific, isometric, and kinetic. Essential tremors are typically intentional or postural, meaning that they are most obvious during directed movements and when standing upright. 

What Causes Essential Tremors? 

The cause of essential tremors isn’t clear, though cerebellar degeneration is a possible factor. The cerebellum is a part of the brain that governs muscle movement. There is also evidence that some cases of ET derive from a genetic mutation. 

Risk factors for essential tremors include being over 40 years old and inheriting the genetic mutation associated with the tremor. The mutated gene is dominant, so having only one parent with it is sufficient for the condition to manifest itself in his or her children. 

How Are Essential Tremors Diagnosed?

There are no standard diagnostic tests for identifying essential tremors. Your physician will record your and your family’s medical history, document your symptoms, and conduct a physical examination. He or she may also conduct other medical tests to rule out alternative diagnoses. These would include neurological, laboratory, and performance tests. The latter would focus on tasks of daily living, such as being able to drink from a glass without shaking or writing your name legibly. Your physician might also order a dopamine-transporter scan, if he or she remains uncertain whether your tremors are ET or Parkinsonian (related to Parkinson’s disease). 

It’s possible that you will be referred to a neurologist for part or all of the diagnostic process. 

How Are Essential Tremors Treated?

Mild versions of ET rarely require treatment. More serious cases can benefit from: 

Medications

Prescription medications are the first line for controlling and minimizing essential tremors. Options include:

• Anti-seizure drugs, including primidone, gabapentin, and topiramate
• Beta blockers, such as propranolol
• Botox injections
• Tranquilizers, such as clonazepam.

Surgery

Surgical procedures are useful if patients don’t respond to medication. Include are:

• Deep-brain stimulation
• Focused ultrasound thalamotomy.

Therapy

Physical and occupational therapy are valuable resources for developing muscle control and diminishing symptoms. 

Can Essential Tremors be Prevented?

There is no cure for ET. There are, however, steps you can take to reduce its impact in your life. Chief among these is avoiding known triggers: cigarettes, caffeine, alcohol, and high levels of psychological stress. 

Learn More About Essential Tremors from Baptist Health

Don’t get shook by ET – we can help. If you or a family member is troubled by essential tremors, make an appointment with your Baptist Health medical provider.