Essential Tremors
What is it?
Essential tremor, also known as intention or familial tremor, is a rhythmic shaking movement caused by involuntary muscle contractions. This tremor, termed essential because it is not related to an underlying disorder, most frequently affects the hands and neck; it generally spares the muscles of the torso and lower limbs. Characteristically, essential tremor becomes more pronounced during activities such as writing or using a knife and fork, as distinguished from tremors in Parkinson's disease, which often diminish with movement (see Parkinson's Disease for more information). Essential tremor usually develops in middle age or later. Symptoms appear gradually. The most common of the so-called shaking disorders, essential tremor is not a serious health risk. It responds well to treatment and in fact seems to be an indicator of an unusually long life.
What Causes It?
- The cause of essential tremor is unknown.
- Genetic factors play a role in about half of all cases (familial tremor).
Prevention
- There is no known way to prevent essential tremor.
Diagnosis
- Patient history and physical examination are needed.
How to Treat It
- Beta-blocking drugs (commonly used to treat high blood pressure) such as propranolol are generally the most effective medications for treating essential tremor.
- Other drugs, including anticonvulsants (such as primidone) and tranquilizers (such as clonazepam, lorazepam, or alprazolam), may be used to treat muscle tremors that do not respond to beta-blockers.
- Patients may be advised to ink one glass of wine or one ounce of 80-proof liquor a day, because alcohol has been shown to ease tremors in some cases. However, sometimes a rebound effect occurs, causing the tremor to worsen after the effect of the alcohol has worn off. In addition, some doctors fear the potential risk of alcohol abuse.
- Avoid the consumption of caffeine and other stimulants, which may exacerbate the tremor.
- In severe, disabling cases that do not respond satisfactorily to medications, controlled injections of botulinum toxin (which causes the muscle paralysis associated with botulism) into muscles of the forearm or neck may stop tremors.
- Surgical destruction of specific cells within the brain, or electrical stimulators implanted in certain regions of the brain, may provide relief from symptoms in severe cases that do not respond to other forms of treatment, but this is done only as a last resort.
When to Call a Doctor
- Make an appointment with a doctor if involuntary trembling or shaking of the hands, head, or other muscles interferes with normal activities.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.