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Essential tremor (ET) is the most common tremor-associated condition and involves a rhythmic shaking of the arms, hands and/or fingers during movement (handwriting, eating, etc).

The experts at Inova Movement Disorders Program are thoroughly experienced in the diagnosis and treatment of essential tremor and can help improve the quality of your life.

Essential tremor has also been known as familial tremor, benign essential tremor or hereditary tremor. It affects an estimated 10 million Americans.  The condition is usually present in multiple family members and classically starts anytime between age 40-90, sometimes earlier.

Essential tremor is the most common form of tremor, up to 8 times more common than the other tremor-associated condition, Parkinson’s disease.

ET exhibits the following characteristics:

  • A rhythmic tremor that can be in the hands, arms, or trunk as well as the head and voice. It does not need to include all of these locations for diagnosis.
  • The arm and hand tremor is usually not present at rest, but appears with most activities that involve moving the arm and hand (eating/drinking, writing, dressing, etc).
  • The head and voice tremor is usually present at rest, and can create a ‘bouncing’ voice.
  • Stress, lack of sleep and caffeine can make the tremor worse.
  • Can be associated with dystonias (hyperlink), which are over-tightening of the muscles of the neck, arms and/or legs.

What Causes Essential Tremor?

The exact cause of essential tremor is not known, but it is thought to be a disorder of the cerebellum, which is the back part of the brain that deals in control of coordination, precision and accuracy of movement. It is known to be a strongly genetic condition; therefore ET classically runs in families.

How Is Essential Tremor Diagnosed?

An accurate diagnosis of essential tremor is key. Currently there are no blood or laboratory tests that are useful in diagnosing essential tremor so it is important to be evaluated and followed by a movement disorders specialist. These specialists have completed extra training specifically in the care of essential tremor.

How Is Essential Tremor Treated?

When symptoms reach a point that they become bothersome, a number of medications exist which can reduce the severity of the tremor. If medications fail to improve the symptoms, deep brain stimulation (DBI) is an FDA-approved technology which boasts the following results:

  • 80 percent improvement in tremor
  • 70 percent improvement in handwriting
  • Significant reduction in medications

What Do I Need to Do Now?

It is very important to be seen by a qualified and experienced movement disorders specialist as early in the course of your condition as possible. Treatments and medications exist that can improve your quality of life now. Research has repeatedly shown that the earlier a patient sees an ET specialist, the quicker the patient's quality of life improves and the longer the benefit is sustained.

For more information on essential tremor, contact Inova Movement Disorders Program at 703-845-1500.

Treatment for essential tremor (ET) is determined by your physician based on:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Type of condition
  • Your tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

We have yet to find a cure for essential tremor. However, based on the severity of the symptoms and medical profile, your doctor will establish an appropriate treatment protocol. Treatment may include the following:

  • Medications
  • Surgery
  • Complementary and supportive therapies, such as diet, exercise, physical therapy, occupational therapy, and speech therapy

Medication for Essential Tremor

Once the diagnosis of ET has been made, the next decision is whether a patient should receive medication based on his or her condition. No two patients react the same way to a given drug. It takes time and patience to find an appropriate medication and dosage to alleviate symptoms.

Surgery for Essential Tremor

Based on the severity of the condition and the medical profile, the doctor may recommend surgery as one treatment option for essential tremor. The main surgery for essential tremor is called deep brain stimulation (DBS). It is aimed at helping the tremor that comes with the disease, though it does not cure the disease or stop the progression of the disease. In most patients, surgery has been shown to decrease the amount of medication that is needed to control the symptoms of ET.

With Deep Brain Stimulation (DBS), a small electrode is placed in the critical parts of the brain that help to control movement. The electrode is attached to a small battery in the chest wall and is connected by wires that are placed under the skin. The stimulator is then turned on and interrupts the flow of abnormal information that causes the tremor of Essential Tremor. On average DBS achieves:

  • 80 percent improvement in tremor
  • 70 percent improvement in handwriting
  • Significant reduction in medications

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