Benign Essential Tremor
(Essential Tremor; Familial Tremor)
Benign essential tremor (ET) is a movement disorder that results in shaking that a person cannot control. It can affect any part of the body, but it is most common in the hands.
The cause is not known. Genes may play a role.
It is more common in people who are more than 60 years of age. It is also more common in people with a family history of ET.
ET is not serious, but it does get worse over time. Symptoms may include:
- Uncontrolled shaking in the hands, arms, head, jaw, legs, or trunk
- Changes in volume and smoothness when speaking
- Tremors that make it hard to do things like write, eat, and drink
Problems may be worse when a person is under stress, upset, or sick.
The doctor will ask about symptoms and health history. A physical exam will be done. A neurological exam may also be done. The doctor will be able to see the tremor. This is enough information to make the diagnosis.
The goal of treatment is to manage symptoms. There is no cure. ET can be managed with lifestyle changes, such as:
- Limiting stress
- Avoiding things that trigger tremors, such as caffeine
- Getting enough rest
Other choices are:
ET cannot be prevented.
Occupational and physical therapy may be needed. This can help find ways to adapt to tremors, such as making changes during meals or using special tools.
Some medicines may make tremors worse. These may need to be stopped or changed. The doctor may also advise medicines to ease symptoms, such as:
- Antiseizure medicines
- Antipsychotic medicines
- Botulinum toxin type A injections
Surgery may be an option for people when other methods do not help. There are two methods:
- Deep brain stimulation (DBS)—sends painless electrical pulses to the brain to interrupt signals causing the tremor
- Thalamotomy—destroys a tiny part of the brain (less common)
- Bhatia, K.P., Bain, P., et al; Tremor Task Force of the International Parkinson and Movement Disorder Society. Consensus Statement on the classification of tremors. Mov Disord, 2018; 33(1): 75-87.
- Essential tremor. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/essential-tremor.
- Muth, C. Essential tremor. JAMA, 2016; 316 (20): 2162.
- The facts about essential tremor. International Essential Tremor Foundation website. Available at: http://essentialtremor.org/wp-content/uploads/2019/06/FactSheet062019.pdf.
- 3/7/2018 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/condition/essential-tremor: Crawford P, Zimmerman EE. Tremor: sorting through the differential diagnosis. Am Fam Physician, 2018; 97 (3): 180-186. Available at: https://www.aafp.org/afp/2018/0201/p180.html.
- Rimas Lukas, MD
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