Essential Tremor

Board-Certified Neurologists Helping Patients Manage Movement Disorders

The Department of Neurosurgery at Rutgers Health and RWJBarnabas Health treats neurological movement disorders, including the most common movement disorder, essential tremor. While this disorder is not life-threatening by itself, the symptoms get progressively worse over time, and it can cause significant impairment. Through the team approach our team takes to treat essential tremor, we can help you improve your quality of life by managing symptoms.

Do you have an essential tremor, or need a second opinion regarding your diagnosis? Contact our Department of Neurosurgery at Rutgers Health and RWJBarnabas, today for help.

What Is an Essential Tremor?

Essential tremor (ET) is the most common movement disorder, characterized by involuntary shaking in different parts of the body. Nationwide, it affects about 7 to 10 million people. Essential tremor usually only affects certain parts of the body. It can cause difficulty holding a full cup without spilling, eating normally, holding a pen and writing legibly, applying makeup and/or shaving. If the voice box or tongue is affected, talking clearly becomes more challenging. Some patients may be at an increased risk of developing dementia, and Alzheimer’s disease, in particular.

Although there currently is no cure for essential tremor, medication can provide patients relief from troubling symptoms. Treatment options may involve medication, surgery, and lifestyle changes.

The body parts most commonly affected by essential tremor include:

  • Hands and arms

  • Face

  • Voice

  • Jaw

  • Tongue

  • Voice box

Is Essential Tremor Related to Parkinson’s Disease?

While they may appear similar, essential tremor and Parkinson’s differ in several important ways:

  • Timing of tremors: Parkinson’s disease tremors are most prominent when a person has their hands at their sides or resting in the lap, whereas essential tremor of the hands is most prominent when you use your hands.

  • Related health problems: Essential tremor is a standalone condition, whereas Parkinson’s disease causes associated conditions, including a stooped posture, a shuffling gait, and slow movement.

  • Body parts affected: Essential tremor rarely affects the lower half of the body. It usually involves only the hands, head, and voice. Parkinson’s disease symptoms begin with tremors of the hands and eventually affect the legs, jaw, and other body areas.

Essential Tremor Causes

The cause of essential tremor is unknown, but it is attributed to abnormal electrical brain activity causing tremors. Risk factors include having a parent with an essential tremor, as is the case for half of people affected. Older age is also associated with essential tremor, as it is most common in adults aged 40 or older. However, essential tremor is not a normal part of the aging process.

How Is Essential Tremor Diagnosed?

There is no specific blood or imaging test to diagnose essential tremor. It is mainly diagnosed based on self-reported symptoms from the patient, as well as what the doctor observes as telltale signs of an essential tremor. Your doctor will also rule out other causes of the tremors, such as thyroid disease or side effects from medication.

Your doctor will start with a neurological examination, which serves to test nervous system functioning, including reflexes, muscle tone, ability to feel certain sensations, and more. Your neurologist will also ask you when your symptoms began, if you have a known family history, if you’ve ever had a head injury, and other questions.

Other tests serve to rule out any condition similar to an essential tremor, including Parkinson’s disease.

Essential Tremor Treatment

  • Medication: Prescription medication can help reduce tremors by as much as 50%. Medicines such as propranolol (a beta blocker), primidone (an anti-seizure drug), and various other medications can be used to manage tremors. Tranquilizer medication such as benzodiazepine drugs can help people whose anxiety worsens tremors, but these drugs must be taken with caution because they carry a high risk of addiction.

  • Botox: Botulinum toxin, or Botox, is an injectable drug used to treat migraines, bladder dysfunction, and excessive sweating. Tremors of the hand, head, or voice box can be treated with Botox to reduce symptoms.

  • Surgery: Patients whose symptoms cannot be managed effectively with medication frequently benefit from deep brain stimulation, a surgical procedure in which electrodes are implanted deep within the brain to offer tremor relief. The procedure is performed using a thin wire to implant the electrodes in the area where the brain is generating the tremor.

  • Focused high intensity ultrasound: Also called stereotactic radiosurgery, a neurosurgeon directs the x-ray or ultrasound to the part of the brain causing tremors.

  • Occupational therapy: An occupational therapist can help you make lifestyle modifications to help improve quality of life, such as using utensils with larger handles, and wearing wrist weights to stabilize your hands.

  • Lifestyle changes: Maintaining a good sleep schedule is important, as fatigue can worsen tremors. Relaxation techniques may also be important to reduce stress, as it also aggravates essential tremor symptoms. Too much caffeine is another aggravating factor for essential tremor symptoms.

Request an appointment online now or call 833-656-3876.