Essential tremor

Essential tremor is a neurological disorder which causes involuntary shaking or trembling of particular parts of the body, usually the head and hands. Sometimes the voice is affected and sounds quavery.

The tremors typically worsen when the hands are being used (kinetic tremor), and reduce significantly or stop altogether when the hands are resting. For some people, the condition worsens if they hold their bodies in certain positions (postural tremor).

Generally, essential tremor gradually gets worse with advancing age. The cause is unknown and there is no cure, although drugs and surgery may help. Older people are most susceptible, but anyone of any age can develop essential tremor – a person can even be born with it. Essential tremor and Parkinson’s disease are different disorders.

Symptoms of essential tremor

The symptoms of essential tremor include:

• Voluntary muscles are affected.
• The hands, head and voice are most commonly affected.
• Head nodding, if the head is affected.
• Shaky, quivering voice – if the voice box (larynx) is affected.
• The tremor is usually mild, rhythmic and fast.
• The tremor is exacerbated by activity or movement.
• The tremor eases when the body part is at rest.
• The tremor stops when the person is asleep.
• The condition worsens with age.
• Other body parts that may become affected, in time, include the arms and eyelids.
• The legs are rarely affected.

Essential tremor is not a form of Parkinson’s disease

Essential tremor and Parkinson’s disease are different disorders. Essential tremor is characterised by shaking when movement is initiated, which can continue or worsen during movement. The symptoms of Parkinson’s disease include involuntary tremor at rest, muscle stiffness, slowness of movement and freezing. Parkinson’s disease is caused by a deficiency of the brain chemical dopamine, which is necessary for smooth and controlled muscular movement.

The cause of essential tremor is unknown

Essential tremor is the most common type of tremor, and affects more people than Parkinson’s disease. Some estimates suggest that around one in five people over the age of 65 years is affected. There is no known cause, but a genetic link is strongly suspected. Each child of a person with essential tremor has a 50 per cent chance of inheriting the disorder themselves. If a person with essential tremor has other affected family members, then the disorder is called ‘familial tremor’.

Factors that worsen essential tremors

Certain factors are known to worsen the condition, including:

• Emotional stress
• Physical activity
• Caffeinated drinks
• Fatigue and insufficient sleep
• Alcohol consumption, in some people.

Quality of life may be affected

Uncontrollable shaking can reduce a person’s quality of life in many ways, including:

• Difficulties with everyday activities, such as writing, getting dressed or eating.
• Irritation and stress caused by the inability to control the affected body part.
• Social embarrassment.
• Increased fatigue which can contribute to weight loss through activity and calorie use.

Essential tremor diagnosis

Essential tremor is diagnosed using a number of tests, including:

• Medical history
• Physical examination
• Electromyography (EMG) test to check the electrical activity of muscles
• Tests to rule out other causes – such as x-rays, blood tests, magnetic resonance imaging (MRI) and computed tomography (CT) scans.

Treatment options for essential tremor

There is no cure for essential tremor. Treatment aims to suppress the involuntary movements, and can include:

• Avoidance of known triggers, such as alcohol or caffeine.
• Stress management techniques.
• Some drugs used to treat other medical conditions, such as heart disease (beta blockers) and epilepsy (anticonvulsants). These drugs have been known to be helpful in some cases.
• Other drugs, including tranquillisers.
• Deep Brain Stimulation, a surgically implanted device that helps to regulate brain waves.
• Brain surgery – success has been found in some cases.
• Regular monitoring and observation – if the tremor is mild and doesn’t stop the person from performing their usual activities this may be the only treatment.

In some cases, alcohol may reduce the tremors. However, this is not a recommended treatment, and long-term consumption of alcohol has significant health risks.

Where to get help

• Your doctor
• Neurologist
• Parkinson’s Victoria Tel. (03) 9581 8700 or 1800 644 189

Things to remember

• Essential tremor is a neurological disorder characterised by the involuntary shaking or trembling of particular parts of the body, usually the head and hands.
• The tremors typically worsen when the hands are being used (kinetic tremor), and reduce significantly or stop altogether when the hands are resting.
• The cause is unknown, although a genetic link is strongly suspected.
• There is no cure for essential tremor.
• Treatment aims to suppress the tremors and includes drugs, surgery and stress management.

You might also be interested in:

• Parkinson's disease.
  

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Parkinson's Victoria Inc

Last reviewed: October 2011

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Essential_tremor?open">Essential tremor - Better Health Channel</a><br/>
Essential tremor is a neurological disorder that causes involuntary shaking of particular parts of the body, usually the head and hands. The cause is unknown, although a genetic link is strongly suspected. Essential tremor is not a form of Parkinson's disease. Triggers may include emotional stress, caffeinated drinks, alcohol or insufficient sleep. There is no cure.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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