Essential Tremor(ET) is a nervous system disorder that causes rhythmic shaking

Essential tremor is a condition that affects the nervous system, causing involuntary and rhythmic shaking or trembling. This shaking is often most obvious in the hands and forearms, but essential tremor can also affect the head, voice, face, and rarely the legs.

This movement disorder is not life threatening. It is sometimes also called benign essential tremor to distinguish it from Parkinson’s disease. Symptoms of essential tremor can still significantly disrupt daily function.

While essential tremor can affect people of any age, the condition occurs more often in people older than 45 years of age. Essential tremor disorder may affect men slightly more than women.

Neurologists attribute ET to a disruption in communication between different parts of the brain, especially within networks involving the cerebellum (which controls and coordinates muscle movement), that results in these abnormal movements.

Essential tremor can run in families. When it does, it may be described as a familial tremor or hereditary tremor. Around half of all people with essential tremor inherit the condition from one of their parents. The exact genetic abnormality that causes inherited essential tremor has not yet been identified yet.

Essential tremor can affect any body part, including:

• Hands and forearms (most common)
• Head
• Arms
• Vocal cords (leading to a soft, shaky, or breathy voice)
• Face
• Legs/feet (rare)
• Trunk

Symptoms of essential tremor vary depending on the affected area of the body. Essential tremor can make activities that require gripping and manipulating small objects difficult, including:

• Dressing
• Drinking
• Eating
• Sewing
• Shaving
• Using tools
• Writing

If ET affects the head, neck, or vocal cords, symptoms may include:

• Uncontrollable nodding or bobbing of the head
• Shaking or trembling of the voice while speaking

Factors that aggravate essential tremor include:

• Caffeine intake or cigarette smoking
• Emotional stress or anxiety
• Exercise, fatigue, or lack of sleep
• Hunger

Rest and Meditation may help alleviate symptoms of ET.

ET vs. Parkinson's:

Parkinson's Disease(PD)causes slowed gait, stooped posture, and shuffling feet. Tremors due to PD are slower, rolling movements over a larger range of motion. In contrast, ET causes faster, smaller, non-rolling movements. PD tremor occurs at rest, while ET occurs during active movement. 

DX: 

Diagnosing essential tremor involves a review of medical history, family history and symptoms and a physical examination. There are no medical tests to diagnose essential tremor. Diagnosing it is often a matter of ruling out other conditions that could be causing symptoms. To do this, a HCP may recommend a visit to a Neurologist.

Blood and urine may be tested for :

• Thyroid disease.
• Metabolic problems.
• Medicine side effects.
• Levels of chemicals that may cause tremor

Treatment: A Neurologist may prescribe Beta Blockers, Anti-seizure meds, Tranquilizers, and Botox. PT may teach exercises to improve muscle strength, control and coordination

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Author

Paddy Kalish OD, JD and B.Arch