Essential tremor is a movement disorder that causes rhythmic shaking of your hands, arms, or head. It is not caused by a medical problem such as Parkinsonâ€™s disease or a stroke. It is also called benign essential tremor because it is not a serious health risk.
What is the cause?
The cause of essential tremor is not known. Tremors may result from problems with the way your brain and nerves send signals to your muscles. You are more likely to have essential tremor if one of your parents had it.
What are the symptoms?
Symptoms may include shaking of your head, hands, or arms, or a voice that sounds shaky. Unless an essential tremor is very severe, your hand or arm does not shake when it is resting. However, your hand or arm does shake when you try to do something such as eating, drinking, writing, or shaving.
The following may make your symptoms worse:
Medicines, such as those used to treat depression or anxiety
Food or drinks that have caffeine in them
Fear or anxiety
Smoking or chewing tobacco
Drugs or alcohol, usually when they begin to wear off
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider will ask about the medicines you take, because some medicines can cause tremors.
There are no tests that can confirm the diagnosis. You may have tests or scans to check for other possible causes of your symptoms. Your provider may refer you to a specialist for tests and treatment.
How is it treated?
You may not need treatment unless the tremors keep you from doing daily activities or are upsetting to you.
Your provider may prescribe medicines to slow the tremor.
If the tremor is severe and disabling, you may have brain surgery called deep brain stimulation. In this surgery, a very thin wire (electrode) is placed into the part of your brain causing symptoms. It is attached by a wire that runs under your skin to a very small device placed under the skin in your upper chest. The device sends small electrical signals to block nerve signals that cause tremors. Surgery is not a cure and is usually only done if medicines do not help.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. In addition:
Pay attention to what makes your tremor better or worse. Are there times of day when your tremor gets worse? Does it seem to be affected by any medicines you take? Does your tremor get worse when you are under stress or when you are tired? This will help you know what you can do to help reduce your tremor, for example:
Use both hands to do tasks whenever possible. Use one hand to steady the other.
To help control head tremors, try bending your chin toward your chest or holding your head to one side.
If your tremor seems to be caused or made worse by a medicine, talk to healthcare provider. Do not change or stop medicines on your own. Donâ€™t take any medicines, including nonprescription products, without first checking with your healthcare provider.
Use tools to help with everyday activities, as needed, such as:
Wear clothing with Velcro instead of zipper or buttons so that it is easy to get on and off.
Use cooking or eating utensils that have a larger handle.
Use lids and straws with drinks.
Wear slip-on shoes and use shoehorns.
Take care of your health. Try to get at least 7 to 9 hours of sleep each night. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress. Exercise according to your healthcare provider’s instructions.
Ask your healthcare provider:
How and when you will hear your test results
If there are activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-07-23 Last reviewed: 2014-07-23
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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Zesiewicz, TA, et al. Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology. 2011 Nov 8;77(19):1752-5.