Essential Tremor

Overview

ET is one of the most common movement disorders. ET is a neurological disorder that causes the hands, head, voice, legs, or trunk to shake rhythmically. Up to 10 million people in the United States and many millions of more people worldwide have ET. While tremor is more commonly seen in older people, ET can affect anyone at any time between early childhood and old age. Researchers estimate that 4 to 5.6% of people aged 40 to 60 have ET. The prevalence rate for people aged 60 and older is estimated at 6.3 to 9%.

Symptoms

ET is the most common cause of tremor. Generally, tremor occurs during action such as eating, drinking, or writing. This is called action tremor or kinetic tremor. The tremor of ET can also occur in positions maintained against gravity such as holding your arms outstretched in front of your body, This is called postural tremor.

ET can be frustrating and embarrassing, and it can even lead to social isolation. In some cases, ET can be quite disabling, causing difficulty with such normal daily activities as writing, eating, drinking, and speaking. In many cases, ET progresses with time, leading to more severe tremor or tremor in additional parts of the body. Sometimes, however, ET progresses so slowly changes may not be apparent in the person’s lifetime.

Causes

Although ET is thought to be related to abnormal functioning of the part of the brain called the cerebellum, no specific brain abnormalities have been confirmed. In most cases, ET appears to be an autosomal dominant disease, which means that each child of a parent with ET has a 50% chance of inheriting ET. However, not everyone, however, who inherits a gene develops ET symptoms. This suggests the possible influence of some not yet identified environmental factors. There is currently no genetic test for ET.

Prevention

Currently there is no way to prevent ET. Perhaps in the future, through research, we will find that answer.

Diagnosis

There are no medical tests to confirm the diagnosis of ET. It is diagnosed by medical history, and neurological evaluation, after which the physician evaluates symptoms and rules out other potential causes of tremor such as:

  • medication side effects
  • thyroid disease
  • excessive stress or trauma
  • excessive use of caffeine or other stimulants
  • presence of other movement disorders such as Parkinson’s disease and dystonia.

During the neurological evaluation, the doctor will generally collect specific information about the tremor.

Prognosis

While there is no cure for ET there are some therapies that can help you live a full and productive life. If you have been diagnosed with ET, visit the IETF website (see Links at right) and request a free information packet to supplement the information provided here. Join a local support group to learn what others have found to be helpful and to share your experiences. Research is being done for essential tremor and the IETF is funding as much research as possible to help find better treatments and a cure.

Treatment

If your ET is mild and not bothersome to you, you may not need treatment. If, on the other hand, ET interferes with your ability to work, perform daily activities, or interact socially, you may want to consider available therapies. Because there is currently no cure for ET and medications are estimated to be effective for about half of patients, it is important for you to have realistic expectations about drug therapy Treatment goals are to reduce the severity of the tremor and to improve daily functioning and quality of life. Achieving these goals may take time because each person responds differently to the available treatments. In addition, you may need to try more than one treatment before you and your physician find the best one for you. There are also surgical options such as deep brain stimulation.

Resources

There are many ways to minimize the degree to which ET interferes with your life and work. Here are some practical suggestions. Learn as much as you can about ET. Make sure your physician is knowledgeable about ET and is actively working with you to control your tremor. Don’t hide your tremor. Talk about it to friends, relatives, and colleagues, The more everyone learns about ET, the faster public awareness will increase. Greater awareness will bring attention to ET and facilitate research so desperately needed to help find appropriate treatments and a cure. If your child has ET, you may want to meet with his/her teacher(s) to discuss. find ways to reduce stress, learn relaxation techniques, avoid caffeine and certain prescription medications.