Essential tremor

Not being able to control your movements is extremely frustrating. Not only does it impact your life physically, but it also can take a toll emotionally.

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

Essential tremor can be difficult to diagnose. HonorHealth's neurologists specialize in movement disorders and have the experience and specialized training to diagnose this condition. Working with our team, we can develop a treatment plan that delays or eliminates tremor symptoms.

Causes and Diagnosis

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.


In its mildest stages, essential tremor presents itself as shaking in the hands. A person might experience minor difficulty with holding small objects steadily. Shaking might also be present in the head, neck and face. The voice might 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 debilitating — to the point where they interfere with everyday activities.


When tremor affects daily living, a long-term treatment plan is necessary. Many patients with mild to moderate tremor respond to medication.

  • Deep brain stimulation might be helpful for severe tremor patients and is becoming an increasingly widespread way to treat 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. 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. When considering this surgical treatment, the neurologist, patient, family members, and caregivers must carefully weigh the risks and benefits.

  • 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 might include slowed a slowed heart rate and fatigue.