Essential tremor

Essential tremor

Essential tremor is a neurological (

nervous system

) disorder which causes involuntary shaking or trembling of particular parts of the body, usually the head and hands. Sometimes the voice is affected, making it sound shaky.

The tremors typically worsen when the hands are being used (kinetic or intention tremor), and reduce significantly or stop altogether when the hands are resting. For some people, the condition worsens if they hold their bodies in certain positions (postural or intention tremor).

Generally speaking, essential tremor gradually gets worse over time and with advancing age. The cause is unknown and there is no cure, although medication and surgery may help. Older people are most susceptible, but anyone of any age can develop essential tremor – a person can even be born with it. Essential tremor and Parkinson’s disease are different disorders.

Symptoms of essential tremor

The symptoms of essential tremor include:

affects the voluntary

muscles

(the muscles that you can consciously move)

head nodding, if the head is affected

shaky, quivering voice, if the

larynx

(voice box) is affected

a small, rapid tremor

tremor that is exacerbated by activity or movement

tremor that eases when the body part is at rest

tremor that stops when the person is asleep

worsening with age

hands, head and voice are most commonly affected

other body parts may become affected over time, including the arms and eyelids (the legs are rarely affected).

Essential tremor is not Parkinson’s disease

Essential tremor and

Parkinson’s disease

are different conditions.

Essential tremor is characterised by shaking when movement starts, which can continue or worsen during movement. The symptoms of Parkinson’s disease include:

involuntary tremor when you are not moving

muscle stiffness

slowness of movement

‘freezing’.

Parkinson’s disease is caused by a lack of supply of the brain chemical dopamine, which is necessary for smooth and controlled muscular movement.

Cause of essential tremor

Essential tremor is the most common type of tremor, and affects more people than Parkinson’s disease. Some estimates suggest that around 1 in 5 people over the age of 65 years is affected.

There is no known cause, but a genetic link is strongly suspected. Each child of a person with essential tremor has a 50% chance of inheriting the disorder themselves. If a person with essential tremor has other affected family members, then the disorder is called ‘familial tremor’. Tremor can occur as a side effect of some medications or exposure to contaminants in the environment (E.g. Mercury).

Factors affecting essential tremors

Certain factors are known to worsen the condition, including:

emotional

stress

physical activity

caffeinated drinks

fatigue

and

insufficient sleep

alcohol

consumption and withdrawl (in some people).

Effects of essential tremor on quality of life

Uncontrollable shaking can reduce a person’s quality of life in many ways, including:

difficulties with everyday activities, such as writing, getting dressed or eating

irritation and

stress

caused by the inability to control the affected body part

social embarrassment

increased

fatigue

.

Diagnosis of essential tremor

Essential tremor is diagnosed using a number of tests, including:

medical history

physical examination

electromyography (EMG) test to check the electrical activity of muscles

tests to rule out other causes – such as

x-rays

,

blood tests

,

magnetic resonance imaging (MRI)

and

computed tomography (CT) scans

.

Treatment of essential tremor

There is no cure for essential tremor. Treatment aims to suppress the involuntary movements. To identify the best treatment, you should consult with a

Neurologist

. Treatments can include:

avoidance of known triggers, such as

alcohol

or

caffeine

stress management techniques

some medications used to treat other medical conditions, such as

heart disease

(beta blockers) and

epilepsy

(anticonvulsants) – these medications have been helpful in some cases

other medications, including tranquillisers

deep brain stimulation, a surgically implanted device that helps to short-circuit the impulses or brain waves causing the tremor

brain surgery to alter the part of the

brain

causing the tremor has been successful in some cases

MRI guided focused

ultrasound

(a treatment for some people with essential tremor, but it’s not covered by Medicare in Australia)

regular monitoring and observation – if the tremor is mild and doesn’t stop the person from performing their usual activities, this may be the only treatment.

In some cases, alcohol may reduce the tremors. However, this is not a recommended treatment, because long-term consumption of alcohol has

significant health risks

.

Where to get help

Your

GP (doctor)

Referral to a

neurologist

Fight

Parkinson’s

External Link

Tel.

1800 644 189

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