Essential Tremor is a nerve disorder characterized by uncontrollable shaking, or " tremors," in different parts and on different sides of the body. Essential tremor is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your. Diagnosis. Diagnosing essential tremor involves reviewing your medical history, family history and symptoms and conducting a physical.
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About 50 percent of the cases of essential tremor are thought to be caused by a genetic risk factor referred to as familial tremor. Children of a parent who has familial tremor have greater risk of inheriting the condition. Familial forms of essential tremor often appear early in life.
For many years essential tremor was not associated with any known disease. However, some scientists think essential tremor is accompanied by a mild degeneration of certain areas of the brain that control movement. This is an ongoing debate in the research field. Dystonic tremor occurs in people who are affected by dystonia— a movement disorder where incorrect messages from the brain cause muscles to be overactive, resulting in abnormal postures or sustained, unwanted movements.
Dystonic tremor usually appears in young or middle-aged adults and can affect any muscle in the body. Symptoms may sometimes be relieved by complete relaxation. Although some of the symptoms are similar, dystonic tremor differs from essential tremor in some ways. Cerebellar tremor is typically a slow, high-amplitude easily visible tremor of the extremities e.
It is caused by damage to the cerebellum and its pathways to other brain regions resulting from a stroke or tumor. Damage also may be caused by disease such as multiple sclerosis or an inherited degenerative disorder such as ataxia in which people lose muscle control in the arms and legs and Fragile X syndrome a disorder marked by a range of intellectual and developmental problems.
It can also result from chronic damage to the cerebellum due to alcoholism. Psychogenic tremor also called functional tremor can appear as any form of tremor. It symptoms may vary but often start abruptly and may affect all body parts. The tremor increases in times of stress and decreases or disappears when distracted. Many individuals with psychogenic tremor have an underlying psychiatric disorder such as depression or post-traumatic stress disorder PTSD.
Physiologic tremor occurs in all healthy individuals. It is rarely visible to the eye and typically involves a fine shaking of both of the hands and also the fingers. It is not considered a disease but is a normal human phenomenon that is the result of physical properties in the body for example, rhythmical activities such as heart beat and muscle activation.
Enhanced physiological tremor is a more noticeable case of physiologic tremor that can be easily seen. It is generally not caused by a neurological disease but by reaction to certain drugs, alcohol withdrawal, or medical conditions including an overactive thyroid and hypoglycemia.
It is usually reversible once the cause is corrected. Generally, symptoms include shaking in one or both hands at rest. It may also affect the chin, lips, face, and legs. The tremor may initially appear in only one limb or on just one side of the body.
As the disease progresses, it may spread to both sides of the body. The tremor is often made worse by stress or strong emotions. Orthostatic tremor is a rare disorder characterized by rapid muscle contractions in the legs that occur when standing.
People typically experience feelings of unsteadiness or imbalance, causing them to immediately attempt to sit or walk. Because the tremor has such a high frequency very fast shaking it may not visible to the naked eye but can be felt by touching the thighs or calves or can be detected by a doctor examining the muscles with a stethoscope.
In some cases the tremor can become more severe over time. The cause of orthostatic tremor is unknown. During the physical evaluation, a doctor will assess the tremor based on:. The doctor will also check other neurological findings such as impaired balance, speech abnormalities, or increased muscle stiffness. Blood or urine tests can rule out metabolic causes such as thyroid malfunction and certain medications that can cause tremor.
These tests may also help to identify contributing causes such as drug interactions, chronic alcoholism, or other conditions or diseases. Diagnostic imaging may help determine if the tremor is the result of damage in the brain. Additional tests may be administered to determine functional limitations such as difficulty with handwriting or the ability to hold a fork or cup. Individuals may be asked to perform a series of tasks or exercises such as placing a finger on the tip of their nose or drawing a spiral.
The doctor may order an electromyogram to diagnose muscle or nerve problems. This test measures involuntary muscle activity and muscle response to nerve stimulation. Although there is no cure for most forms of tremor, treatment options are available to help manage symptoms.
Finding an appropriate treatment depends on an accurate diagnosis of the cause. Tremor caused by underlying health problems can sometimes be improved or eliminated entirely with treatment. For example, tremor due to thyroid hyperactivity will improve or even resolve return to the normal state with treatment of thyroid malfunction.
Also, if tremor is caused by medication, discontinuing the tremor-causing drug may reduce or eliminate this tremor. If there is no underlying cause for tremor that can be modified, available treatment options include:. The treatment is approved only for those individuals with essential tremor who do not respond well to anticonvulsant or beta-blocking drugs. When people do not respond to drug therapies or have a severe tremor that significantly impacts their daily life, a doctor may recommend surgical interventions such as deep brain stimulation DBS or very rarely, thalamotomy.
While DBS is usually well tolerated, the most common side effects of tremor surgery include dysarthria trouble speaking and balance problems. Tremor is not considered a life-threating condition. Although many cases of tremor are mild, tremor can be very disabling for other people. It can be difficult for individuals with tremor to perform normal daily activities such as working, bathing, dressing, and eating. The symptoms of essential tremor usually worsen with age.
Unlike essential tremor, the symptoms of physiologic and drug-induced tremor do not generally worsen over time and can often be improved or eliminated once the underlying causes are treated.
The mission of the National Institute of Neurological Disorders and Stroke NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. But it can affect people at any age. The condition seems to run in families. For some people, essential tremor is mild and never gets any worse. For other people, it starts on one side of the body and eventually affects both sides. The hands are the most common part of the body affected.
Some people also have changes in the way they walk gait. The cerebellum is the part of the brain that controls muscle coordination. People with essential tremor have shaking and trembling at different times and in different cases. But some symptoms are common to all. Here are symptoms you might have:. Your healthcare provider will ask you questions about your health history and family history. He or she will also look at your trembling symptoms.
Your provider will probably need to rule out other conditions that could cause the shaking or trembling. For example, tremors can be symptoms of diseases like hyperthyroidism or Parkinson disease. Your provider might also test you for these diseases. In some cases, the tremors might be related to other factors. To find out for sure, your provider may have you:. Several medicines are available to treat essential tremor. Some affect how brain nerves work.
This can calm your trembling. Sometimes antiseizure medicines are prescribed. Tranquilizers are other medicines that may be given for essential tremor. For severe tremors, your healthcare provider may suggest that a stimulating device be implanted in your brain.
Tremor Fact Sheet
Essential tremor is a neurological disorder that causes a part of your body to shake uncontrollably. Find out what you can do to manage your symptoms. Essential tremor causes involuntary shaking or trembling of particular parts of the body, usually the head and hands, but it is not Parkinson's disease. Essential tremor (previously also called benign essential tremor or familial tremor ) is one of the most common movement disorders. The exact cause of essential.