Essential tremor (ET) is the most common movement disorder. It is characterized by a chronic, involuntary, rhythmic tremor, usually of the arm and hand but sometimes of the head, voice, and tongue. At first, the tremor affects one side of the body, but eventually it may involve both sides of the body. The tremors most often occur when the arms are held out in front of the body or during activities of daily living such as eating or drinking. The disorder impairs fine motor skills, which may include writing, eating, and using utensils.
Essential tremor can occur sporadically but is most often inherited. It usually begins between the ages of 40 and 50. 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 may also be useful, as tremors tend to increase with stress.
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