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essential tremor

Alternative Names
benign essential tremor, senile tremor, hereditary essential tremor, familial tremor

Definition
Essential tremor consists of fine, rhythmic, shaky movements that usually involve the hands and sometimes the head. The voice can also be affected.

What is going on in the body?
No one knows exactly what happens in the body to cause these noticeable tremors.

What are the signs and symptoms of the condition?
The symptoms of this condition include rhythmic trembling in one or both hands and sometimes the head. A shaky voice can develop. The tremors are generally mild and only happen occasionally at first, but slowly worsen with age.

The tremor is more noticeable when the hands are in use. Rest generally relieves it.

What are the causes and risks of the condition?
There are no known causes or risks of essential tremor, except heredity. When there is a family history of a similar tremor, the condition is called familial tremor. The trembling is aggravated by:
  • stress
  • caffeine
  • not getting enough sleep
  • it can be temporarily relieved with alcohol
What can be done to prevent the condition?
Currently, there is no known way to prevent essential tremor.

How is the condition diagnosed?
Tremor is usually diagnosed by observation. Rarely, a test called electromyography (EMG) that checks electrical activity in a set of muscles is done to confirm the diagnosis. An overactive thyroid gland, called hyperthyroidism, can mimic essential tremor. This condition is usually ruled out by blood tests.

A person who comes to a doctor with essential tremor is often concerned about Parkinson's disease. Usually, this type of tremor can be distinguished from the tremor caused by Parkinson's disease.

What are the long-term effects of the condition?
Over time, the tremor can become severe enough to interfere with any activity that calls for fine motor skills, such as:
  • writing
  • eating
  • drinking
  • dressing
What are the treatments for the condition?
Medications used to treat this condition include:
  • propranolol and other beta blockers.
  • primidone.
  • clonazepam.
Very fine-tuned surgery on the part of the brain that relays certain sensory information and electrical stimulation may be done, too, though this treatment is still experimental.

What are the side effects of the treatments?
Potential drug side effects include:
  • slowing of pulse and lowering of blood pressure
  • fatigue.
  • light-headedness.
  • sleepiness.
  • nightmares
Potential risks of surgery include infection and bleeding in the brain.

What happens after treatment for the condition?
The tremor can often be improved, but not completely stopped by medication or surgery. A person may find that symptoms grow worse with time, but this varies.

How is the condition monitored?
A doctor should monitor the condition.

Author: Michael Curiel, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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