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Considered the most common movement disorder, essential tremor affects as many as 10 million Americans. The condition is eight times more prevalent than Parkinson's, and can emerge at any age.
By definition, tremor is a rhythmic movement produced as a result of involuntary muscle contractions. Essential tremor is called "essential" because it is not caused by other diseases.
Essential tremor can be difficult to diagnose. A neurologist who specializes in movement disorders has the experience and specialized training needed to diagnose the condition properly.
You'll find these movement disorders specialists at John C. Lincoln. By promptly and accurately diagnosing essential tremor, our specialized neurologists can develop a treatment plan that delays or eliminates tremor symptoms.
Throughout the course of assessment and treatment, our specialists listen closely to our patients — to determine the right therapeutic course, aware that patients may respond differently to treatments.
Essential Tremor Causes
The treatment plan for essential tremor starts with taking a family health history. Genetics can play a role in approximately half of all cases of essential tremor. This form of tremor is called "familial tremor."
A movement disorders specialist will also take care to rule out complications involving medications and hyperthyroidism, for example.
Beyond genetics, the precise, underlying causes of tremor are unknown. Diagnostic imaging techniques have linked essential tremor with abnormal activity in certain parts of the brain. The thalamus — a structure situated deep within the brain that controls muscle activity — is one area of research. Yet, ultimately, more research is needed.
Essential Tremor Symptoms
In its mildest stages, essential tremor presents itself as shaking in the hands. One may experience minor difficulty with holding small objects steady. Shaking may also be present in the head, neck and face. The voice may quiver or sound shaky.
Some patients have tremor only in certain postural positions (referred to as "postural tremor"). When tremors worsen during voluntary movements, such as eating or writing, a patient is said to have "kinetic tremors." Most people with essential tremor experience both postural tremor and kinetic tremor.
As essential tremor symptoms worsen, shaking can become severe, even debilitative — to the point where they interfere with routine, everyday activities.
Essential Tremor Treatment
When tremor affects daily living, a long-term treatment plan is necessary. Many patients with mild to moderate tremor respond to medication. Surgical treatment, involving deep brain stimulation, may be helpful for severe tremor patients.
Drug therapies include "beta blockers," which have been used for decades. Beta blockers are thought to be effective because they block nerve impulses in muscles. However, these drugs do not completely suppress tremor, and side effects may include slowed a slowed heart rate and fatigue.
Deep brain stimulation is becoming an increasingly widespread means of treating essential tremor. In this treatment, a neurosurgeon will implant tiny wires in different areas of the brain, to block messages from the thalamus. Depending on the severity of the tremors, electrical current can be adjusted. When considering this surgical treatment, the neurologist, patient, family members, and caregivers must carefully weigh the risks and benefits.
At John C. Lincoln, a highly trained movement disorders specialist can "program" this impulse generator so that it sends the proper amount of electrical signals to the brain. Adjustments to the electrical current can be made without further surgery.