We have changed our visitation policy for the safety of our patients and staff. Click here for the updated visitation policy and click here for information about COVID-19.

Lahey Health is now part of Beth Israel Lahey Health

(Essential Tremor; Familial Tremor)

Definition

Benign essential tremor (ET) is a movement disorder that results in shaking that a person cannot control. It can affect any part of the body, but it is most common in the hands.

Causes

The cause is not known. Genes may play a role.

Risk Factors

It is more common in people who are 60 years of age and older. It is also more common in people with a family history of ET.

Symptoms

ET is not serious, but it does get worse over time. Symptoms may include:

  • Uncontrolled shaking in the hands, arms, head, jaw, legs, or trunk
  • Changes in volume and smoothness when speaking
  • Tremors that make it hard to do things like write, eat, and drink

Problems may be worse when a person is under stress, upset, or sick.

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. A neurological exam may also be done. The doctor will be able to see the tremor. This is enough information to make the diagnosis.

Treatment

There is no cure. The goal is to manage symptoms. This can be done with lifestyle changes, such as:

  • Limiting stress
  • Avoiding things that trigger tremors, such as caffeine
  • Getting enough rest

Other choices are:

Therapy

Occupational and physical therapy may be needed. This can help find ways to adapt to tremors, such as making changes during meals or using special tools.

Medication

Some medicines may make tremors worse. These may need to be stopped or changed. The doctor may also advise medicines to ease symptoms, such as:

Surgery

Surgery may be an option for people who are not helped by other methods. There are two methods:

  • Deep brain stimulation (DBS)—sends painless electrical pulses to the brain, interrupting faulty signals
  • Thalamotomy—destroys a tiny part of the brain (less common)

Prevention

There are no current guidelines to prevent ET.

RESOURCES

International Essential Tremor Foundation  http://www.essentialtremor.org 

National Institute of Neurological Disorders and Stroke  http://www.ninds.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

Parkinson Canada  http://www.parkinson.ca 

References

About essential tremor. International Essential Tremor Foundation website. Available at: http://essentialtremor.org/about-et. Accessed February 21, 2018.

Bega D, Gonzalez-Latapi P, et al. Is there a role for DAT-SPECT imaging in a specialty movement disorders practice? Neurodegener Dis. 2015;15(2):81-86.

Bhatia KP, Bain P, et al; Tremor Task Force of the International Parkinson and Movement Disorder Society. Consensus Statement on the classification of tremors. Mov Disord. 2018 Jan;33(1):75-87.

Essential tremor. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/essential-tremor  . Updated July 17, 2019. Accessed April 8, 2020.

Muth C. Essential tremor. JAMA. 2016;316(20):2162. Available at: https://jamanetwork.com/journals/jama/fullarticle/2585981. Accessed April 8, 2020.

3/7/2018 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/condition/essential-tremor  : Crawford P, Zimmerman EE. Tremor: sorting through the differential diagnosis. Am Fam Physician. 2018;97(3):180-186. Available at: https://www.aafp.org/afp/2018/0201/p180.html.

Revision Information

  • Reviewer: EBSCO Medical Review Board Rimas Lukas, MD
  • Review Date: 02/2020
  • Update Date: 04/08/2020