The Facts about Essential Tremor

Share |

Visit www.essentialtremor.org/Free-ET-Publications to download the free flyer Facts about ET and other helpful materials.

More about ET from the Cleveland Clinic Journal of Medicine

ET is a neurological disorder that causes hands, heads and voices, and sometimes legs and trunk to shake. Occassionally someone will also experience an internal tremor.

An estimated 10 million Americans have ET.

There is evidence that ET is genetic. Each child of a parent who has ET has a 50% chance of inheriting a gene that causes the condition. However, sometimes people with no family history of tremor develop ET.

ET is the most common cause of tremor, although many other causes exist.

Misdiagnosis of tremor is a problem. According to the Canadian Journal of Neuroscience, general neurologists treating tremor have a diagnostic error rate of 25-35%.

ET is often misdiagnosed as Parkinson's disease. According to the National Institutes of Neurological Disorders and Stroke, eight times as many people have ET as have Parkinson's.

ET is not confined to the elderly. Children and middle-aged people can also have ET. In fact, newborns have been diagnosed with the condition.

Few effective prescription medications are available for treating ET. Unfortunately, it is estimated that less than 60% of people with ET are helped by these medications.

Researchers estimate that 4-5% of people age 40 to 60 have ET. The incidence rate for people age 60 and older is estimated at 6.3-9%.

People who have ET become disabled at worst and feel frustrated or embarrassed at best.

Quality of life is big issue for people with ET. Daily activities such as feeding, drinking, grooming and writing become difficult if not impossible. Many people with ET are too embarrassed to go into public and so remain isolated in their homes.

About Head Tremors

The second most frequent body part affected by essential tremor is the head. Essential tremor of the head is characterized by a horizontal "no-no" tremor pattern (tremblement negatif) or a vertical "yes-yes" pattern (tremblement affirmatif). Although head tremor usually develops after hand tremor, the absence of hand tremor is not uncommon. Other body parts such as the legs, chin, trunk, tongue, soft palate and rarely the lips and eyebrows may also be affected. In addition, women are more likely to develop head tremor than men.

Like most forms of tremor, head tremor can be difficult to accurately diagnose. Head tremor patients are often examined while seated in a chair that does not provide complete support for the head, neck, torso, and limb muscles. Consequently, the muscles of these body parts are active against gravity, producing a tremor that can be mistakenly classified as rest tremor. This common error can be avoided by making sure you are examined in a reclined or seated position, with complete body support.

If you have head tremor, there is good evidence supporting the use of the beta-blocker Propranolol as a treatment option. Moderate evidence shows that Botulinum Toxin A injections are effective and may be considered for hard-to-manage head and voice tremor.

Sometimes head tremor is actually a manifestation of Dystonia, which is a different sort of movement disorder. If it's a jaw tremor rather than whole head, then this may be the first signs of Parkinson's disease. There's no substitute for an experienced physician looking at your tremor and doing a few simple maneuvers during a physical exam to characterize the movement.

It is best to see a doctor who has experience with tremor and movement disorders for diagnosis (see our list). You should have a thorough evaluation by a neurologist. He or she will examine the parts of your body that are shaking and determine if it is indeed essential tremor or some another condition. Remember, not every treatment works for every patient. Your doctor will recommend an individualized treatment plan, including lifestyle changes that may reduce your tremor. A treatment decision will depend on other medical conditions you have and potential side effects. All treatments have some side effects; the choice of which side effects can be tolerated depends on the individual.

Citations
Hubble JP, Busenbark KL, Pahwa R, Lyons K, Koller WC. Clinical expression of essential tremor:
Effects of gender and age. Mov Disord 1997;12:969-972.

Jankovic J, Fahn S. Physiologic and pathologic tremors. Diagnosis, mechanism, and management.
Ann Intern Med. 1980;93:460-5.

Louis ED, Ford B, Frucht S. Factors associated with increased risk of head tremor in essential tremor:
A community-based study in northern manhattan. Mov Disord 2003;18:432-436.

Latest Announcements