by Annie Stuart
En Espaol (Spanish Version) Benign essential tremor (ET) is a movement disorder most commonly characterized by shaking in the hands. It may also cause shaking of the head, voice, arms, and trunk, and less often, of the legs and feet. Two types of tremor are common with ET:
Postural tremorshaking in certain positions only, such as with arms outstretched
Kinetic or action tremorshaking that gets worse during activities, such as eating or shaving
In some cases, ET can be socially isolating. It may interfere with normal daily activities such as writing or speaking. If so, contact your doctor for an evaluation.
The cause of ET is unknown. However, it does run in families. When inherited, it is often called familial tremor. Children of parents with ET have a 50% chance of inheriting the condition.
In cases where there is no family history of tremor, other factors such as toxins may play a role, though this is far from clear. It is thought that essential tremor arises from abnormalities of specific circuits in the brain. This is actively being investigated by researchers.
Benign essential tremor occur when faulty nerve cells (or circuits) in the brain send abnormal signals to muscles.
2008 Nucleus Medical Art, Inc. Risk FactorsA risk factor is something that increases your chances of getting a disease or condition. Family history of tremors is the only known risk factor for ET. Although the condition may occur at any age, it is more likely to occur in people older than 40 years old. Symptoms ET is generally not serious, but its severity may vary and worsen over time. Symptoms of ET may include: Uncontrollable, rhythmic, up-and-down movementShaking in hands, arms, head, voice, trunk, legs, or feet on both sidesShaking only in certain positions or during activityTrouble with fine motor skills such as drawing, sewing, or playing an instrumentShaking that gets worse from caffeine, stress, fatigue, or heatTo be considered as having ET, tremors must not be related to other health conditions. Diagnosis Your doctor will ask about your symptoms and your medical and family history, and perform a physical exam, paying particular attention to your neurologic system. At this time, there are no special tests used to diagnose ET. But you may have blood, urine, or other tests such as an MRI to rule out other causes of tremulousness, such as: Parkinson's diseaseElevated thyroid hormoneLow blood sugarStrokeMedications Treatment Most people with ET do not require treatment. Mild tremors may be relieved or even eliminated by simple measures, including:
Staying well-restedAvoiding caffeineAvoiding stimulants often found in over-the-counter medications like cold remediesAvoiding temperature extremesTalk to your doctor about any medications that may be contributing to your symptoms. If your symptoms are troubling, the following treatment options may be helpful: MedicationBeta-blocker (propranolol), a blood pressure medicationAnti-seizure medications (primidone, gabapentin, topiramate)Sedatives (benzodiazepines)Botulinum injections (Botox) is used in rare situations Surgery In rare cases where tremors are very disabling and medications dont help, surgery may be an option. Two approaches are possible. Deep brain stimulation (DBS)transmits painless electrical pulses to the brain, interrupting faulty signals.Thalamotomydestroys a tiny part of the brain generating the tremors. This is less commonly performed than DBS. PreventionThere is no known way to prevent ET. RESOURCES: International Essential Tremor Foundation (IETF)http://essentialtremor.org WE MOVE (Worldwide Education and Awareness for Movement Disorders)http://www.wemove.org CANADIAN RESOURCES: BC Health Guidehttp://www.bchealthguide.org Parkinson Society Canadahttp://www.parkinson.ca References:
Essential tremor. American Academy of Family Physicians website. Available at: http://familydoctor.org/807.xml?printxml . Accessed August 4, 2005. Essential tremor. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00367 . Accessed August 4, 2005. Introductory packet. International Essential Tremor Foundation website. Available at: http://essentialtremor.org/ . Accessed August 4, 2005. Jacques D, Young R, Essential tremor. International Radiosurgery Support Association website. Available at: http://www.irsa.org/essential_tremor.html . Accessed August 4, 2005. Lorenz D, Deuschl G. Update on pathogenesis and treatment of essential tremor. Current Opinions in Neurology . 2007;20:447-452. What is essential tremor? Who gets ET? International Essential Tremor Foundation website. Available at: http://essentialtremor.org/about_us/about_essential_tremor.php . Accessed August 4, 2005. Last reviewed January 2008 by Rimas Lukas, MDPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
