What is Essential Tremor?

How Is ET Different from Parkinson’s Disease?

•  ET usually affects both hands and is most noticeable when you’re using them (for example, eating, writing, or drinking).
• In contrast, Parkinson’s tremors often occur at rest and are usually asymmetric (worse on one side).
• ET does not typically cause slowness, stiffness, or walking difficulties early in the disease like Parkinson’s does.

What Causes Essential Tremor?

The exact cause of ET is not fully understood, but it may be linked to abnormal communication between certain areas of the brain, such as the cerebellum.

In about 50% of cases, it is inherited in families (called familial tremor).

Diagnosis

There is no single test to confirm ET. Diagnosis is based on:

• Medical history
• Physical and neurological exams
• Ruling out other causes (like medications or thyroid issues)

Sometimes, neuroimaging or lab tests are done to exclude other conditions.

Treatment Options

There is no cure for ET, but many people find relief through lifestyle changes, medications, and in some cases, procedures. The goal of treatment is to reduce tremor severity and improve function.

1. Lifestyle and Self-Management

• Use weighted utensils, cups, or pens
• Avoid caffeine and stress, which can make tremors worse
• Engage in occupational therapy for adaptive strategies
• Use voice-assisted devices and keyboards if the tremor affects communication

2. Medications

These are often tried first, depending on the severity and your medical history:

• Propranolol (a beta-blocker): Often the first-line treatment
• Primidone (an anti-seizure medication): May be used alone or with propranolol
• Other options include:
  
  • Gabapentin
  • Topiramate
  • Benzodiazepines (like clonazepam) – used cautiously due to sedation risk

Note: Not all medications work for everyone, and side effects can occur.

3. Advanced Therapies

Considered when tremors are severe and disabling:

• Deep Brain Stimulation (DBS):
  • A surgically implanted device that sends electrical impulses to specific brain areas
  • Effective for hand tremor, especially if medications don’t work
• Focused Ultrasound (FUS):
  • A non-invasive procedure using MRI-guided ultrasound to ablate a small area of the brain
  • Usually performed on one side of the brain and FDA-approved for ET. Second side of the brain can be done 6 months later

Emotional Impact

Living with ET can cause frustration, embarrassment, or social anxiety. Support groups, therapy, and speaking openly with friends and family can be helpful. You’re not alone, and treatment can help you regain control.

At NeuroMotion Telehealth, we are committed to helping you live more confidently with ET.