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 outstretchedKinetic 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.
For some people, essential tremor is caused by a genetic mutation. For others, the cause is not clear.
A family history of tremors is the only known risk factor for essential tremor. The condition may occur at any age. It is more likely to occur in teens and people older than 50 years old.
Essential tremor (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 restUncontrollable, rhythmic movementShaking most common in hands, arms, head, or voiceShaking only in certain positions or during activityTrouble with fine motor skills such as drawing, sewing, or playing an instrumentChanges in volume and smoothness while speakingShaking that gets worse from caffeine, stress, fatigue, or heatShaking that may decrease when using alcoholHearing lossProblems 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.
You will be asked 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 essential tremor.
Most people with essential tremor 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 extremes
The following treatment options may be helpful:
Benign essential tremor may be treated with: Beta-blockersAntiseizure medicationsBenzodiazepinesAntipsychoticsBotulinum injections
Surgery may be an option in rare cases where tremors are disabling and medications do not help. Two approaches are possible. Deep brain stimulation (DBS)—sends painless electrical pulses to the brain, interrupting faulty signalsThalamotomy—destroys a tiny part of the brain (less commonly performed than DBS)
There are no current guidelines to prevent benign essential tremor.
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Last reviewed February 2016 by Rimas Lukas, MD
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