Skip to Content

Disclaimer

Disclaimer
MDS makes every effort to publish accurate information on the website. "Google Translate" is provided as a free tool for visitors to read content in one's native language. Translations are not guaranteed to be 100% accurate. Neither MDS nor its employees assume liability for erroneous translations of website content.

International Parkinson and Movement Disorder Society
Main Content

Essential Tremor: Essential Facts for Patients

What Is It?

Essential tremor (ET) is the most common movement disorder. It is also known as benign essential tremor, familial tremor, or hereditary tremor.  Patients with ET may experience uncontrollable shaking (tremor) in the hands, head, voice, or other body parts. The condi­tion usually begins as an adult and may gradually become worse with age. Tremor is typically most noticeable when holding the hands outstretched or making fine hand movements, such as holding a cup, using a spoon, or writing. The tremor usually stops if the hands/arms are completely relaxed, such as when resting in the lap. Stress often makes the tremor temporarily worse.
 

What Is the Cause?

The cause of ET is unknown, but more than half of patients have another family member with tremor. Researchers have not found the gene(s) that cause ET. For patients with a family history of ET, symptoms tend to begin at an earlier age. Researchers think ET develops in the brain, but patients’ brain scans appear normal.

There is no diagnostic test for ET. However, your doctor may test your blood for other conditions such as thyroid disease that could worsen the tremor. Some medications may also worsen tremor.
 

Is There a Treatment?

There is effective treatment to lessen the tremor, but there is no cure. Using weighted cups, uten­sils, and even wearing small wrist weights can help some patients. Some patients may benefit from medications. Medications are usually given on a trial-and-error basis. Some work better than others depending on the individual patient. Medications that may help include:

  • Beta-blockers, such as propranolol
  • Anti-seizure medications, such as primidone, gabapentin, topiramate, and clonazepam

Your doctor may suggest cutting back on caffeine, other stimulants, and some tremor-producing medications. Patients with certain types of tremor may benefit from botulinum toxin injections.  Botulinum toxin is injected into the muscles that cause the tremor, temporarily weakening the muscle to reduce the tremor. These injections must be repeated two to four times per year and are most effective for patients with head or voice tremor.

Although medical treatment may help some patients with tremor, and should be tried first, those with severe tremor may consider a surgical procedure.  Your neu­rologist can advise you on the most appropriate treatment options for your condition. There is more than one type of surgery for ET, they are:

  • Thalamotomy: a type of brain surgery where one part of the brain, the thalamus, is destroyed
  • Deep Brain Stimulation (DBS): another type of thalamus surgery where a thin wire (also called an electrode) is placed into the thalamus and connected to a pacemaker-like device under the skin in the chest
  • Other surgical procedures
     

Is Essential Tremor a Form of Parkinson’s Disease?

No. ET is about 10 times more common than Parkin­son’s disease (PD). Unlike ET, the hand tremor of PD is most obvious when a patient’s hands are relaxed and not when they are being used for activities. Other signs of PD, but not ET, include slowness of move­ment, walking difficulties, and other exam findings.
 

What Can I Expect as I Live with ET?

ET does not shorten your life expectancy. Tremor may increase over time, but the change is usually slow, typically over many years. Eventually some patients may experience a degree of disability, such as difficulty writing, eating, and drinking or even embarrassment. Mild tremor does not typically require treatment, and early treatment does not stop or slow the symptoms’ natural changes. Only consider starting medication treatment when the tremor affects your daily activities or causes problems for you.

 

Copyright © 2018 International Parkinson and Movement Disorder Society (MDS).  All rights reserved.

 

Handouts

View these essential facts in a variety of languages. 

 

Language

Please wait while we gather your results.

Essential Tremor (Arabic)

Language
  • Alarabia (ألعربيه ) - Arabic

Essential Tremor (Dutch)

Language
  • Nederlands - Dutch

Essential Tremor (Armenian)

Language
  • Հայերէն - Armenian

Essential Tremor (Bangla)

Language
  • বাংলা - Bangla

Essential Tremor (Estonian)

Language
  • Eesti keel - Estonian

Essential Tremor (Bulgarian)

Language
  • български - Bulgarian

Essential Tremor (French)

Language
  • Français - French

Essential Tremor (Croatian)

Language
  • Hrvatski - Croatian

Essential Tremor (German)

Language
  • Deutsch - German

Essential Tremor (Czech)

Language
  • Čeština - Czech

Essential Tremor (Greek)

Language
  • ελληνικά - Greek

Essential Tremor (Danish)

Language
  • Dansk - Danish

Essential Tremor (Hebrew)

Language
  • עברית - Hebrew

We use cookies to give you the best possible experience with our website. These cookies are also used to ensure we show you content that is relevant to you. If you continue without changing your settings, you are agreeing to our use of cookies to improve your user experience. You can click the cookie settings link on our website to change your cookie settings at any time. Note: The MDS site uses related multiple domains, including mds.movementdisorders.org and mds.execinc.com. This cookie policy only covers the primary movementdisorders.org and mdscongress.org domain. Please refer to the MDS Privacy Policy for information on how to configure cookies for all other domains on the MDS site.
Cookie PolicyPrivacy Notice