Essential tremor can occur sporadically but is most often inherited. It usually begins before age 50 and after age 40. Men and women are affected equally. The disease is slowly progressive; however, some patients may experience periods when the disease is relatively stable. Essential tremor is thought to be caused by an abnormal communication between certain areas of the brain.
Essential tremor is diagnosed by careful physical and neurological examination. No blood, urine, or other tests are specific for essential tremor. Imaging studies of the brain are not required for diagnosis but may be used to rule out other potential causes of tremor.
Treatment is usually initiated when the tremor interferes with the patient's ability to perform daily tasks, to work, or to interact socially. Medication cannot cure essential tremor, but it can help reduce the tremor. The primary medications used to treat essential tremor are propandol (Inderal) and primidone (Mysoline). When medication fails to control the tremor adequately, deep brain stimulation may be considered. Occupational therapy and physical therapy also may help patients. Wrist weights or weighted utensils may help to dampen the tremor. Relaxation techniques or biofeedback also may be useful because tremors tend to increase with stress.
