Essential Tremor: What It Is, Causes, Symptoms & Treatment

Experts don’t know exactly why essential tremor happens or if there are triggers that cause them to happen. However, there’s evidence that it happens because of the changes in certain parts of your brain. Or you might be referred immediately to a doctor trained in brain and nervous system conditions, called a neurologist. Support groups aren’t for everyone, but you might find it helpful to have the encouragement of people who understand what you’re going through. Or see a counselor or social worker who can help you meet the challenges of living with essential tremor.

Risk factors

Dystonic tremor occurs in people who are affected by dystonia—a movement disorder in which incorrect messages from the brain cause muscles to be overactive, resulting in abnormal postures or sustained, unwanted movements. The disorder usually appears in young or middle-aged adults and can affect any muscle in the body, but most commonly affects the neck (cervical dystonia), vocal cords (laryngeal dystonia), or arms/legs (limb dystonia). A person with dystonic tremor can sometimes relieve their tremor by relaxing completely or touching the affected body part or muscle. The presence of tremor in other locations such as the legs, head, or voice is allowed.

How common is essential tremor?

You should tell your doctor about factors that worsen or alleviate the tremor. It is not clearly understood how this genetic change leads to essential tremor. However, it is likely that it somehow affects some parts of the brain that are responsible for controlling movement.

Essential Tremor Disorder

The medications that are effective for treating essential tremor are not helpful in treating seizures or Parkinson’s disease. And the medications that are used for treating seizures or Parkinson’s disease are not helpful for preventing or treating essential tremor. Generally, essential tremor begins during adulthood, and it can be more common with advancing age. According to a review published in The BMJ, essential tremor affects approximately 1% of the population and 4% to 5% of people over age 65.

In some patients, tremors can be reduced by weighting the limb, usually by applying wrist weights. In a small proportion of patients, this can dampen the tremor enough to provide some relief or improve functioning. Since anxiety and stress classically make the tremor worse, essential tremor alcohol non-medical relaxation techniques and biofeedback can be effective in some patients. Medications known to make tremors worse should be eliminated or minimized when possible. People with tremors also may benefit from avoiding dietary stimulants, such as caffeine.

Essential tremor symptoms

• Tremor is usually described based on frequency of oscillations (rapid or slow) and amplitude of movement (fine [low amplitude] or coarse [high amplitude]).
• Propanolol and primidone are two of the medicines often prescribed to treat essential tremor.

There are medical and non-medical therapies available for essential tremor, but there is no evidence to support one over the other. The pharmacists should explain to the patient the types of drugs available, their side effects, and their benefits. Many people with essential tremor respond to ethanol (alcohol); however, it is not clear why or how. NINDS researchers are studying the impact of ethanol on tremor to determine the correct dosage amount and its physiological impact on the brain, and whether other medications without the side effects of ethanol can be effective. You should schedule to see your healthcare provider if you start to have unexplained shaking or tremors. Your healthcare provider will schedule regular follow-up visits to monitor your condition and adjust treatments as necessary.

Drugs & Supplements

A prospective, multicenter, randomized trial also reported sustained benefit at two year follow-up, with 62% of patients showing a 50% improvement in tremor rating. Mild progression of tremor and disability scores was seen between years one and two.170 Adverse reactions are summarized in table 2. Vocal tremor is a clinical manifestation of essential tremor.

• The drug is usually well tolerated with few side effects (sedation, irritability, ataxia, weight gain).
• In an open label prospective trial, 37 patients received olanzapine, most taking mg daily in divided doses.140 Tremor significantly improved, and the effect was maintained over six months.
• Laboratory evaluation may include tests of thyroid function, urinary copper, and ceruloplasmin to exclude Wilson disease, screening for heavy metal poisoning such as lead if any of these causes are suspected.

Medications and other treatment methods