Learn more about the diagnosis, progression and treatment of this common condition.
Essential tremor is a neurological disorder that causes involuntary rhythmic shaking (tremor) when trying to do things, which can sometimes make tasks difficult. Often essential tremor begins with the hands, but it can also affect the head or voice. Although tremors can occur because of other causes, essential tremor is the most common diagnosis. If you or a loved one has been diagnosed with essential tremor, you may have several questions about the condition.
“I think a lot of times patients and family members don’t realize it’s a really common problem,” said Heather Koons, M.D., a neurologist with Vanderbilt Neurology. “I have a lot of patients who have stopped going to church or to a restaurant because they were embarrassed by their tremor.”
We asked Dr. Koons the top five most common questions patients and caregivers ask her about essential tremor.
Is essential tremor inherited?
Usually, one of the first questions Koons said patients ask is whether this condition runs in families. And the answer is yes, it is frequently genetic. “It’s very common to have family members also affected,” Koons explained. “Although, even within one family, there’s a wide variety of age of onset and severity.”
Although a tremor can impact daily life at any age, Koons added that patients most often seek treatment when they are in their 50s or 60s. However, sometimes patients will look back and remember having tremors as early as adolescence. “Many times they’ve been there for decades before they get bad enough to seek care,” she said. But she sees patients of all ages for this condition.
Is it Parkinson’s disease?
Koons said many people experiencing tremor are wondering if they have Parkinson’s disease. But essential tremor and Parkinson’s disease are different.
“Essential tremor is the most common cause of tremors that occur with action and tend to get in the way of things like writing, eating, and brushing your teeth,” Koons explained. “With Parkinson’s disease, people have tremors at rest, and the condition is associated with a variety of other symptoms such as slowness, stiffness, changes in walking.”
Other things, like medications and less common diseases, can also cause tremor. Koons said a health-care provider will ask questions, perform a physical exam, and take all information into consideration to make sure patients receive the right diagnosis.
Will essential tremor get worse?
Essential tremor generally progresses over time. “How fast it changes and how much worse it gets is highly variable among patients,” Koons said. “So for some folks, it can be mild for decades and not be that problematic. And for some folks, it can really impact their daily life.” Studies have shown that less than 10% of patients with essential tremor develop significant disabilities.
What are the treatments?
If essential tremor is affecting your daily life, you may be wondering what can help. “Unfortunately we can’t cure tremors,” Koons said. “We can’t make them completely go away or get at the underlying cause of the tremor. However, we have a wide variety of very effective therapies.”
How aggressive should therapy be?
Therapies range from behavioral modifications to medications to surgery. “There are lots of factors that go into choosing which therapy might be the best for an individual patient,” she added.
Treatment for essential tremor is individualized. “How aggressive to be with therapy is really driven by how bothersome the tremor is to the patient,” Koons said. “Every patient and their health-care providers work together to explore options, define goals of care, and balance benefits with side effects and risks.”
Vanderbilt’s Movement Disorders Clinic provides advanced care to those experiencing involuntary and excess movement, impaired balance and coordination, muscle rigidity, slow movement or other symptoms. The clinic specializes in treating Parkinson’s disease, dystonia, tremors and spasticity resulting from stroke, multiple sclerosis and head injuries.