Essential tremor (ET) is a common nerve disorder that causes uncontrollable shaking in various parts of the body, most often affecting the hands, arms, head, voice box, tongue, and chin. While not life-threatening, ET can make everyday activities like eating, dressing, or writing challenging. Understanding the causes, symptoms, and treatment options can help those with ET manage their condition and improve their quality of life.
The exact cause of essential tremor is not well understood, but doctors believe it is related to unusual electrical brain activity processed through the thalamus, a structure deep in the brain that controls muscle activity. In about half of all cases, ET is caused by genetic factors and can be passed down from parent to child.
Essential tremor is the most common movement disorder, affecting up to 10 million people in the United States. It can occur at any age but most often appears during adolescence or middle age (between 40 and 50 years old).
The main symptoms of essential tremor include:
Uncontrollable shaking for brief periods
Shaking voice
Nodding head
Tremors that worsen with emotional stress or purposeful movement
Tremors that lessen with rest
Balance problems (in rare cases)
A neurologist or movement disorder specialist can usually diagnose essential tremor based on a person's symptoms and a complete neurological exam. There is no specific blood, urine, or other test used to diagnose ET. During the exam, the doctor may consider other causes of tremor, such as thyroid disease, excessive caffeine intake, or medication side effects.
Treatment for essential tremor depends on the severity of the condition and how much it impacts a person's daily life. Options include:
Oral medications such as gabapentin, primidone, propranolol, and topiramate can help reduce the severity of essential tremor. Benzodiazepines and Botox injections may also be effective for some people.
External devices such as neuromodulation devices and tremor cancellation devices can help control tremors, allowing people with ET to perform daily tasks more easily.
For severe cases of essential tremor that do not respond well to medications, surgical treatments such as deep brain stimulation (DBS), MRI-guided focused high-intensity ultrasound, and thalamotomy may be considered.
Currently, there is no known way to prevent or cure essential tremor. However, ongoing research into the genetic link and causes of ET may lead to new treatments and prevention strategies in the future. While there is no cure, working closely with a doctor to develop a personalized treatment plan can help manage symptoms and improve quality of life for those living with essential tremor.
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