Essential Tremor

Essential Tremor (ET) is a common movement disorder that involves unintentional, somewhat rhythmic muscle movements or tremors in different parts and on different sides of the body. Areas affected often include hands, forearms, head, voice or chin. ET is not a life-threatening disease and it is sometimes called benign essential tremor for that reason, but it is a life-altering condition. According to the National Institute of Neurological Disorders and Stroke (NINDS), ET is the most common form of abnormal tremor, although other tremor causes exist such as Parkinson's disease or stroke. (Read about "Parkinson's Disease" "Stroke") The International Essential Tremor Foundation (IETF) estimates ten million Americans have ET and eight times as many people have ET as have Parkinson's disease.

Symptoms

IETF lists these symptoms of ET:

• rhythmic shaking of the hands, head, tongue, larynx or other parts of the body - the speed of the shaking movements may be rapid or moderate.
• worsening of the tremor under the following conditions:
  • emotional or physical stress (Read about "Stress")
  • voluntary movement of the hands, head and other muscles
  • trying to hold the head or hands still
• tremors stop when at rest
• shaky handwriting
• quavering voice
• head nodding

Causes

The cause of essential tremor is unknown. According to IETF, genetic factors (Read about "Genetics") may play a role in about half the cases only. ET most often affects older people, but it can occur at any age, even in young children. ET is typically progressive, getting worse as people age.

Treatments

IETF lists no cure for ET and patients with mild symptoms may not require any treatment. A few effective prescription medications are available for treating ET. Unfortunately, IETF estimates less than 60 percent of patients are helped by these medications.

Sometimes surgery is an option when tremors are disabling and medications do not produce results. A procedure called a thalamotomy destroys a small part of the brain (the thalamus) which controls some involuntary movements. (Read about "The Brain") The Food and Drug Administration (FDA) has also approved an ultrasound device to treat essential tremor in patients who have not responded to medication. The device uses magnetic resonance images taken during the procedure to deliver focused ultrasound to destroy brain tissue in the area of the brain thought to be responsible for causing tremors. (Read about "MRI - Magnetic Resonance Imaging")

IETF recommends seeing a doctor with experience in movement disorders. Care and treatment options can hinge on the results of an in-depth neurological evaluation and expert diagnosis. Your doctor may alsorecommend diet or lifestyle changes.

Coping

Living with any movement disorder can be difficult, frustrating and in some cases embarrassing. You may find it helpful to talk to a therapist or join a support group to talk to others who truly understand what you're going through. IETF lists these coping tips:

• Keep a positive attitude.
• Reduce stress through meditation or exercise.
• Keep elbows close to your body when performing tasks to reduce hand tremor.
• Do tasks slowly.

NINDS conducts ongoing research into the causes and treatments of ET, so consult with your healthcare provider regularly. Take an active role in educating, managing and understanding your condition.