Essential Tremor


Essential tremor is a disease that causes trembling in the arms, legs or head. It typically involves shaking of the arms when attempting to perform simple tasks such as eating, drinking, writing or shaving. By definition, essential tremor is not caused by other diseases or conditions, although it is sometimes confused with Parkinson’s disease. It can occur at any age but is most common in older adults. It frequently occurs in families and is often referred to “benign familial tremor.”


Essential tremor usually involves tremor of the upper extremities, legs or head. It begins gradually and worsens with time. The tremor is often exacerbated with movement. Tremor symptoms are often aggravated by emotional stress, fatigue or caffeine.


Essential tremor is usually diagnosed by a neurologist during a clinical examination.


The treatments for essential tremor often begin with the use of neurological medications. Common medications used to treat essential tremor include beta blockers such as Propranolol and antiseizure medications such as Mysoline. Occasionally, Botulinum Toxin Type A (Botox injections) are used to control tremor. The most effective treatment available today for essential tremor is deep brain stimulation surgery. This procedure involves inserting a long, thin electrical probe into the thalamus portion of the brain, which is responsible for causing tremor. A wire from the probe is tunneled under the skin to the chest where a pacemaker device is inserted. This device transmits painless electrical pulses to interrupt signals from the thalamus that may be causing the tremors.


While deep brain stimulation surgery is usually reserved for severe cases of essential tremor, it is often very effective in controlling the symptoms.  This usually allows the patient to perform simple activities of daily living more effectively.

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