Essential Tremor, Familial Tremor and Other Tremors

Essential tremor and other tremors are nerve disorders which occur when a person moves or tries to move. The cerebellum, a part of the brain that coordinates muscle movements, does not appear to work properly in these patients, who are most commonly over age 65. Tremor can be the symptom of a variety of neurological conditions.

There may be as many as 10 million people with essential tremor in the United States alone and many more worldwide. Essential tremor is the most common neurologic disease except for stroke, and it is even more frequently diagnosed than Parkinson's disease.

Types of Tremor

Essential Tremor

Essential tremor is a tremor not tied to any other condition. The cause of essential tremor is not known, but it likely has a genetic basis, and often times several generations of a family are affected. Essential tremor is most often seen in the hands, however it’s rhythmic shaking can affect almost any part of the body, including the legs, head and voice.

Familial Tremor

Familial tremor is an essential tremor that occurs in more than one member of a family.

Physiologic Tremor

Physiologic tremor is a fine tremor that occurs in all contracting muscle groups, especially in the hands, and is most often accelerated by stress, anxiety, medications and caffeine.

Primary Orthostatic Tremor

Primary orthostatic tremor is a unique syndrome, identified by a high frequency of tremors in the trunk and legs that occurs only while standing still. There is no tremor or symptoms while sitting or lying down and rarely when walking. It is common to feel dizzy or unsteady when standing up from a seated position. The tremor can be relieved by constantly moving the feet or marching in place.

Task and Position-Specific Tremor

Task and position-specific tremor is a tremor that occurs when a specific task is undertaken, such as writing.

Diagnosing and Treating Essential Tremor

Diagnosis is made after obtaining a complete medical history (including family history) and performing a thorough neurological evaluation. Tests may be ordered to determine if medical or lifestyle factors are contributing to the tremor.

There are a variety of treatments for tremor, including medication. Deep brain stimulation (DBS) has been safely and effectively used to treat essential and other tremors for 20 years when other treatments have failed.

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