What Is Essential Tremor?
Essential tremor (ET) is a nervous system disorder that causes uncontrollable shaking (tremors). It’s one of the most common movement disorders, affecting millions of people worldwide.
It’s usually seen in the hands, but can also affect your head, voice and other parts of the body. ET tremors tend to get worse when you’re doing something, like eating, writing or getting dressed. This is different from Parkinson's, where tremors happen when you’re resting.
Causes of Essential Tremor
People of any age can have ET, but it’s most common in those over 40. Researchers are still figuring out the exact cause of ET. It’s thought to be a mix of genetics (familial tremor) and changes inside certain parts of the brain.
What Are the Symptoms?
The main symptom of ET is rhythmic shaking when you move. The severity can vary greatly from person to person.
- Hand Tremors: The most common, making everyday tasks like writing or drinking from a cup challenging
- Head Tremors: Might look like a “yes-yes” or “no-no” motion
- Voice Tremors: Can cause your voice to sound shaky when you talk
- Leg Tremors: Less common, but can affect walking and balance
Stress, tiredness, caffeine and some medications can make these tremors worse.
How is ET Diagnosed?
Diagnosing ET usually involves a detailed medical history and a neurological exam. There’s no specific test for ET, so doctors often rule out other conditions first. This may be done through blood work or imaging tests like MRIs or CT scans.
Treatment Options
While there is no cure for essential tremor, several treatments can help manage the symptoms:
- Medications: Doctors often prescribe beta-blockers or anti-seizure meds to help reduce tremors. In some cases, benzodiazepines or botulinum toxin (Botox) injections might be used.
- Lifestyle Changes: Limiting caffeine and stress and using special tools like weighted utensils can help you handle daily tasks better.
- Physical and Occupational Therapies: These can help improve your muscle control and coordination, making everyday activities easier.
- Surgical Options: For severe cases that don’t respond to medication, treatments like deep brain stimulation (DBS) can be effective. DBS involves implanting electrodes in the brain to regulate abnormal activity and control the disabling tremors.
Another effective, less invasive treatment is focused ultrasound. Carilion Clinic Neurosurgery’s Mark Witcher, MD, is the first in the region to offer the procedure. “Focused ultrasound is an incisionless procedure that allows us to use sound waves to create a small lesion within the brain, which stops tremor immediately,” he explains.
The procedure is painless, and patients can expect an improvement in symptoms of about 80%. And since there are no incisions or full anesthesia, patients are often able to return home the same day!
If you have symptoms of ET, reach out to your doctor. They can evaluate your condition and recommend next steps.
