Essential tremor

Essential tremor is a movement disorder that causes shaking that you can’t control. At Atrium Health Floyd and Harbin Clinic, our neurologists provide compassionate, expert care to help you manage this condition.

What is an essential tremor?

Everyone has some natural tremor (shaking), but usually the movements are so small that you don’t notice them. Essential tremor is when this shaking becomes more severe. Your hands, head or other body parts may shake noticeably in a way you can't control.

Essential tremor is not life-threatening and doesn’t always require treatment. However, in more advanced stages, the condition can interfere with daily activities or harm your mental health.

Causes of essential tremor

Experts don't know the exact cause of essential tremor. Researchers believe that the part of the brain that controls muscle movements may not work properly in people with this condition. Essential tremor can also run in families.

Essential tremor symptoms

The most common symptom of essential tremor is small, rapid movements that occur four to 12 times per second. These tremors usually affect your arms, hands, head or eyelids. Less commonly, tremors can occur in your legs or feet.

You may notice that the tremors cause:

• Difficulty writing, drawing, drinking from a cup or using tools
• Head nodding
• Shaking or quivering voice

The tremors may:

• Become more frequent or noticeable with age
• Improve slightly when you drink a small amount of alcohol, although alcohol is not a treatment for this condition
• Occur more when you’re moving than when you're resting
• Worsen with caffeine, lack of sleep or stress

Essential tremor diagnosis

Doctors diagnose essential tremor by first performing a physical exam and ruling out other medical conditions. Your doctor may also order blood tests to check your overall health and imaging tests, such as a CT scan or MRI, to look at your brain.

Your doctor may ask about your use of certain substances that can lead to shaking, such as:

• Alcohol
• Caffeine
• Certain medications
• Tobacco products

Essential tremor risk factors

About half of all people with essential tremor have a family history of the condition. In this case, the condition is called a familial tremor. However, some people develop the condition without a family history.

Essential tremor is an autosomal dominant condition. That means you have a 50% chance of inheriting essential tremor if one of your parents has the gene.

Essential tremor prevention

There is no known way to prevent essential tremor. However, managing your stress levels and avoiding triggers like caffeine may improve your symptoms.

Some medications, such as certain antidepressants and immune system suppressants, can cause tremors as a side effect. Talk with your provider about whether a medication you're taking could be causing your tremors.

Essential tremor treatment

Essential tremor doesn’t always require treatment. However, if symptoms interfere with your life, treatment options may include:

• Medications: Medications that may help reduce essential tremor symptoms include anti-seizure medicines, calcium-channel blockers, Botox injections, and mild tranquilizers.
• Neurological physical therapy: Your physical therapy team will develop a personalized plan to help you maintain your physical function and quality of life.
• Surgery: Surgery may be an option in severe cases when other treatments haven’t been successful. Essential tremor surgery may involve focusing high-powered X-rays on a small area of the brain (stereotactic radiosurgery). Another option involves implanting a stimulating device in the part of the brain that controls movement.