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Essential Tremor: Causes, Symptoms, Diagnosis, and Treatment

When symptoms are socially bothersome or interfere with activities of daily living, patients often seek medical intervention. Propranolol (Inderal) and primidone (Mysoline) are most effective in reducing tremors. Propranolol is a beta blocker, also used to treat high blood pressure and performance anxiety.

Essential tremor is the most common neurologic disorder that affects postural or action tremors. The worldwide estimated prevalence is up to 5% of the population. Family history can be found in near 50% of cases and in 90% concordance in monozygotic twins.

Alcohol responsiveness

In some cases, the tremor can become more severe over time. Vocal tremor is a clinical manifestation of essential tremor. Older studies included patients who would not meet modern definitions of essential tremor owing to lack of arm involvement. This is concerning, as isolated vocal tremor is typically due to an alternate diagnosis (dystonia).

The key is first to educate the patient on the disorder and its treatment. For those not impaired by the disorder, only observation is recommended. There are medical and non-medical therapies available for essential tremor, but there is no evidence to support one over the other. The pharmacists should explain to the patient the types of drugs available, their side effects, and their benefits.

How can I reduce my risk of developing essential tremor or prevent it altogether?

It is equally common in men and women and is more common with increasing age. Most people who develop essential tremor are aged over 40 but it can occur in younger people. Other NIH researchers hope to identify the source of essential tremor, study the effects of currently available tremor-suppressant drugs on the brain, and develop more targeted and effective therapies. Medications are effective in about 50 percent of individuals with tremor.

Comprehensive search strategies covered the topics of diagnosis, medical and surgical management, and drug treatment in essential tremor. A combination of subject headers and keywords was designed in conjunction with a essential tremors and alcohol medical librarian. The searches were executed in the Medline (PubMed) and Embase (Ovid) databases from database inception through 25 February 2019. Non-systematic reviews were weighted lower than systematic reviews.

Drug treatment

Essential tremor may be inherited, but it can also occur in people who don’t have a family history of the condition. Tremors can be caused by alcohol abuse, an overactive thyroid, or a stroke. They can also be caused by a variety of neurological conditions. But these tremors aren’t characterized as essential tremors. Essential tremor is usually not a dangerous condition, but it typically worsens over time and can be severe in some people.

essential tremors

Some tremor can be triggered by stress or strong emotion, being physically tired, or being in certain postures or making specific movements. MRI guided high intensity focused ultrasound (MRIgFUS) is a lesional surgery that is less invasive than DBS. The current procedure allows penetration of the skull without heating of the bone. There is not an identified and consistent cause of essential tremor. Experts agree that there is likely a genetic component, and it sometimes runs in families. However, there is no identified single gene that is known to cause essential tremor.

Your doctor can usually diagnose essential tremor based on your explanation of the tremor and an examination. It is important for your doctor to make sure that there are no other conditions present that are causing tremor. In some cases, this may mean that you need to have some tests to rule out other conditions. You may also be referred to a doctor with a special interest and expertise in the brain and nerves (a neurologist). However, other studies have shown it may affect as many as 1 in 17 people.

  • When essential tremor interferes with independent living or holding a job, it can be devastating.
  • For this reason, alcohol can sometimes be used to diagnose ET.
  • Someone who has ET will have up to a 50% chance of passing down the responsible gene to their child, but the child may never have symptoms.
  • It’s located on one of the nonsex chromosomes, called autosomes.
  • Fortunately, there are medications that help control the essential tremor symptoms, and ways to make the tasks of daily living easier.

Often, your insurer’s customer service number is printed on the back of your insurance card. In most cases, Mayo Clinic doesn’t require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need. Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. The information on this page is written and peer reviewed by qualified clinicians.


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