Find a Physician
- Find a Physician
  - Affiliated Practices
  - Find a Physician
  This section contains information to help make finding a doctor or physician practice affiliated with West Florida Hospital easier.
Services
- Services
  At West Florida Hospital, we treat the most important health concerns - yours. We provide healthcare services designed to meet your needs at every stage of your life.
Patients & Visitors
- Patients & Visitors
  Patient care is our most important job. We want to make sure your experience is as pleasant as possible. This section contains information to help make your stay with us as comfortable as possible.
Health Information
- Health Information
  The more you know about your health, the better prepared you are to make informed healthcare decisions. Our health library gives you the information you need to take charge of your health.
For Professionals
- For Professionals
  This section is specifically for healthcare professionals, including physicians, mid-level providers, nurses, and other medical professionals.

Benign Essential Tremor

Home
Health Information
Condition Detail

(Essential Tremor; Familial Tremor)

Definition

Benign essential tremor (ET) is a movement disorder most commonly noticed by shaking in the hands. It occurs in about 5% of older adults. It may also cause shaking of the head, voice, arms, and trunk. It occurs less often in the legs and feet. Two types of tremor are common with ET:

Postural tremor—shaking in certain positions only, such as with arms outstretched
Kinetic or action tremor—shaking that gets worse during activities, such as eating or shaving

ET can be socially isolating in some cases. It may interfere with normal daily activities such as writing or speaking.

Causes

For some people ET is caused by a genetic mutation, but for others the cause is not clear.

Risk Factors

Family history of tremors is the only known risk factor for ET. The condition may occur at any age. It is more likely to occur in teens and people older than 50 years old.

Symptoms

ET is generally not serious, but its severity may vary and worsen over time. Symptoms may include:

Tremor that occurs when standing or moving the limbs, but not usually at rest
Uncontrollable, rhythmic movement
Shaking most common in hands, arms, head, or voice
Shaking only in certain positions or during activity
Trouble with fine motor skills, such as drawing, sewing, or playing an instrument
Shaking that gets worse from caffeine, stress, fatigue, or heat
Shaking may decrease when using alcohol
Hearing loss
Problems with social, functional, or job-related abilities in more severe cases

Tremors must not be related to other health conditions in order for someone to have the ET diagnosis.

Diagnosis

Your doctor will ask about your symptoms, and your medical and family history. A physical exam will be done. Attention will be paid to the central nervous system. There are no special tests to diagnose ET. You may have blood, urine, or other tests to rule out other causes, like:

Parkinson's disease
Elevated thyroid hormone
Low blood sugar
Stroke
Medication side effects

Treatment

Most people with ET do not require treatment. Mild tremors may be relieved or even eliminated by simple measures, including:

Staying well-rested
Avoiding caffeine
Avoiding stimulants often found in over-the-counter medications, like cold remedies
Avoiding temperature extremes

The following treatment options may be helpful:

Medication

Beta-blocker
Anti-seizure medications
Benzodiazepines
Antipsychotics
Botulinum injections

Surgery

Surgery may be an option in rare cases where tremors are disabling and medications don’t help. Two approaches are possible.

Deep brain stimulation (DBS)—sends painless electrical pulses to the brain, interrupting faulty signals.
Thalamotomy—destroys a tiny part of the brain (less commonly performed than DBS)

Prevention

There is no known way to prevent ET.

RESOURCES

International Essential Tremor Foundation http://essentialtremor.org

WE MOVE http://www.wemove.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Parkinson Society Canada http://www.parkinson.ca

References

Essential tremor. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated October 10, 2012. Accessed May 22, 2013.

Essential tremor. International Radiosurgery Support Association website. Available at: http://www.irsa.org/essential%5Ftremor.html. Accessed May 22, 2013.

Facts about essential tremor. International Essential Tremor Foundation website. Available at: http://essentialtremor.org/siteresources/data/files/free%20et%20publications/factsheet012013.pdf. Accessed May 22, 2013.

Lorenz D, Deuschl G. Update on pathogenesis and treatment of essential tremor. Current Opinions in Neurology. 2007;20:447-452.

Sadeghi R, Ondo WG. Pharmacological management of essential tremor. Drugs. 2010:70(17):2215-28.

Smaga S. Tremor. Am Fam Physician. 2003;68(8):1545-1552.

What is essential tremor? Who gets ET? International Essential Tremor Foundation website. Available at: http://essentialtremor.org/About-ET . Accessed November 12, 2012.

Revision Information

Reviewer: Rimas Lukas, MD; Brian Randall, MD
Review Date: 05/2013 -
Update Date: 05/22/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Find a Physician

Services

Patients & Visitors

Health Information

For Professionals