Essential tremor

Essential tremor, also known as benign essential tremor is an involuntary (i.e. it happens without your consciousness) and uncontrolled shaking movement of your body parts. It is a very common disorder and doesn’t cause any serious health issues. It is sometimes confused with Parkinson’s tremor as both the conditions share common symptoms.
Essential tremor is a brain disorder which usually affects a part of your body. Most commonly hands and forearms are affected. The other parts which can get affected include head, neck face, tongue, and torso. Rarely legs and feet can also get affected.

Symptoms

Tremors which occur with essential tremor can range from mild to severe. It can affect any side of the body and with different intensity.

It often causes small and rapid movements (usually about 5 times per second) which are especially noticeable during activities. Tremors can occur occasionally, or frequently or constantly.

Essential tremor symptoms in different parts of the body are:

  • A noticeable shaking movement of the hands and the arms while doing simple activities with your hands (for example drinking, eating, writing, drawing, etc.).
  • Tremors in the neck are visible as up-and-down or side-to-side motion.
  • Tremors in parts of your face cause twitching of the part (for example, eye twitching).
  • Tremors in the tongue can cause a quivering voice while speaking.
  • In legs and feet, tremors can lead to an imbalance, difficulty in gait and an abnormal appearance while standing or walking.

Causes

There are no underlying essential tremors causes. The exact cause of tremors is not known. However, it is believed to be due to certain genetic and environmental factors.

Tremors caused by an overactive thyroid, alcohol abuse, stroke, certain neurological conditions such as Parkinson’s disease are not considered as essential tremors.

Tremors can worsen due to certain factors including stress, fatigue, hunger, smoke, extreme climatic conditions, caffeinated drinks, etc.

Risk factors

Age: Tremors can affect a person at any age but is more common in elderly people especially above 40 years of age.

Genetics: Genes are also known to play a role in causing tremors. The chance of you passing this disorder to your child is nearly 50%.

Gender: Tremors can equally affect both the genders.

Diagnosis

Diagnosing tremors is quite easy. Your doctor will notice the signs and symptoms, ask you about your medical and family history. Further, certain specific tests are carried out to exclude any other reasons for tremors.

Blood tests and imaging tests (X-rays, CT, MRI, etc.) do not show any abnormalities.

Treatment

Essential tremors cannot be cured, but the progression to more severe form can be delayed with treatment. Treatment is not required if the symptoms are minor. However, if the symptoms are affecting your daily activities, then you will need essential tremor treatment. The treatment options for essential tremors are:

 

Medications

  • Beta-blockers (e.g. propranolol): These agents reduce the secretion of the chemical called adrenaline thereby reducing tremors
  • Blood pressure medications (e.g. flunizarine): Reduce the levels of adrenaline
  • Anticonvulsants (e.g. primidone): Work to reduce nerve cell excitability
  • Mild tranquilizers (e.g. alprazolam): Is one of the treatment options

Surgery

When all the other therapies fail, surgery may be required. The surgical procedures include deep brain stimulation using electrodes placed in the brain, stereotactic radiosurgery using X-rays to correct portion of the brain to reduce tremors.

Other therapies include physical therapy to improve muscle coordination and control. Botox injections can weaken the muscles and help to minimize tremors.

Self-management

Certain tips can help you manage doing activities when you have essential tremors.

  • Cooking and eating in large sized vessels
  • Using straws to drink
  • Wearing slip-on shoes and shirts with press buttons
  • Avoiding caffeinated drinks
  • Doing relaxation techniques to reduce stress