Benign essential tremor (ET) is a movement disorder most commonly characterized by shaking in the hands. It occurs in as much as 10% of people over the age of 60. It may also cause shaking of the head, voice, arms, and trunk, and less often, of the legs and feet. Two types of tremor are common with ET:
In some cases, ET can be socially isolating. It may interfere with normal daily activities, such as writing or speaking. If so, contact your doctor for an evaluation.
The cause of ET is unknown. However, it does run in families. When inherited, it is often called familial tremor. Children of parents with ET have a 50% chance of inheriting the condition.
In cases where there is no family history of tremor, other factors, such as toxins, may play a role, though this is far from clear. It is thought that essential tremor arises from abnormalities of specific circuits in the brain. This is an area that researchers are studying.
Family history of tremors is the only known risk factor for ET. Although the condition may occur at any age, it is more likely to occur in people older than 40 years old.
ET is generally not serious, but its severity may vary and worsen over time. Symptoms may include:
To be considered as having ET, tremors must not be related to other health conditions.
Your doctor will ask about your symptoms and your medical and family history. He will also do a physical exam, paying particular attention to the central nervous system. At this time, there are no special tests to diagnose ET. But, you may have blood, urine, or other tests (eg, MRI ) to rule out other causes, like:
Most people with ET do not require treatment. Mild tremors may be relieved or even eliminated by simple measures, including:
Talk to your doctor about any medications that may be contributing to your symptoms. If your symptoms are troubling, the following treatment options may be helpful:
In rare cases where tremors are very disabling and medications don’t help, surgery may be an option. Two approaches are possible.
RESOURCES:
International Essential Tremor Foundation
http://essentialtremor.org/
WE MOVE
http://www.wemove.org/
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html/
Parkinson Society Canada
http://www.parkinson.ca/
References:
Elble RJ. Essential tremor. In: Gilman S, ed. MedLink Neurology website. Available at: http://www.medlink.com . Accessed February 4, 2009.
Essential tremor. American Academy of Family Physicians website. Available at: http://familydoctor.org/807.xml?printxml . Accessed August 4, 2005.
Essential tremor. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00367 . Accessed August 4, 2005.
Introductory packet. International Essential Tremor Foundation website. Available at: http://essentialtremor.org/ . Accessed August 4, 2005.
Jacques D, Young R, Essential tremor. International Radiosurgery Support Association website. Available at: http://www.irsa.org/essential_tremor.html . Accessed August 4, 2005.
Jankovic J, Shannon KM. Movement disorders. In: Bradley WG, ed. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth Heinemann Elsevier; 2008.
Lorenz D, Deuschl G. Update on pathogenesis and treatment of essential tremor. Current Opinions in Neurology . 2007;20:447-452.
What is essential tremor? Who gets ET? International Essential Tremor Foundation website. Available at: http://essentialtremor.org/about_us/about_essential_tremor.php . Accessed August 4, 2005.
Last reviewed January 2009 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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