Essential tremor

What is essential tremor?

Essential tremor is a nervous system condition that causes uncontrollable shaking. Your hands may be affected first. It is not usually dangerous but can get worse over time. It can become severe in some people.

What are the symptoms of essential tremor?

The most common symptom is shaking of one or both of your hands when they’re being used. This is different to the shaking of the hands in people with Parkinson’s disease. Usually their hands also shake at rest.

Your head and voice may also be affected by essential tremor.

Having an essential tremor affects people in different ways. You may find your symptoms:

• are not too much of a problem
• are embarrassing or upsetting
• cause trouble with things like:
  • holding and drinking a cup of coffee
  • writing clearly
  • putting on make-up or shaving

What causes essential tremor?

You have a 1 in 2 chance of inheriting essential tremor if one of your parents has it. It isn’t known what causes essential tremor in other people.

Essential tremor is more common in older people but can happen at any age.

Essential tremor doesn’t cause any other conditions. It’s also not caused by other conditions.

How is essential tremor diagnosed?

There are no special tests for diagnosing essential tremor. Your doctor will usually ask about your: symptoms, medical history and family history. Your doctor may do a physical exam. You may need blood tests too.

How is essential tremor treated?

If your symptoms aren’t bothering you too much, you might not need treatment.

You might find there are things that make your tremor worse. These may be:

• stress
• caffeine
• alcohol
• some medicines, such as
  • asthma medicines
  • stimulants used for attention deficit hyperactivity disorder (ADHD)
  • lithium

Avoiding these triggers may help reduce your shaking.

Physiotherapy or occupational therapy might help you manage your shaking.

If it’s difficult for you to work or do normal daily activities, your doctor might prescribe medicine such as:

• propranolol — a betablocker
• primidone — an anti-seizure medicine

Always ask your doctor before stopping or changing your medicines.

If you still have severe shaking after avoiding your triggers and taking prescribed medicines your doctor may suggest surgery.

Surgery to treat essential tremor may involve stimulation of the thalamus (a part of the brain). This procedure is known as ‘deep brain stimulation’.

If you notice that your hands shake talk to your doctor to get the right diagnosis and treatment.