Neurology

Conditions We Treat

Essential Tremor

Tremor is an unintentional, somewhat rhythmic, muscle movement involving to-and-fro movements (oscillations) of one or more parts of the body. Essential tremor (sometimes called benign essential tremor) is the most common of the more than 20 types of tremor. Although it may be mild and nonprogressive in some people, in others the tremor is slowly progressive, starting on one side of the body but eventually affecting both sides.

Hand tremor is most common but the head, arms, voice, tongue, legs, and trunk may also be involved. Hand tremor may cause problems with purposeful movements such as eating, writing, sewing, or shaving. Head tremor may be seen as a "yes-yes" or "no-no" motion. Essential tremor may be accompanied by mild gait disturbance.

Heightened emotion, stress, fever, physical exhaustion, or low blood sugar may trigger tremors or increase their severity. Onset is most common after age 40, although symptoms can appear at any age. Children of a parent who has essential tremor have a 50% chance of inheriting the condition. Essential tremor is not associated with any known pathology.

Treatment

There is no definitive cure for essential tremor. Symptomatic drug therapy may include propranolol or other beta blockers and primidone, an anticonvulsant drug. Eliminating tremor "triggers" such as caffeine and other stimulants from the diet is often recommended. Physical therapy may help to reduce tremor and improve coordination and muscle control for some patients.

Prognosis

Although essential tremor is not life-threatening, it can make it harder to perform daily tasks and is embarrassing to some people. Tremor frequency may decrease as the person ages, but the severity may increase, affecting the person's ability to perform certain tasks or activities of daily living. In many people the tremor may be mild throughout life.

Helpful Resources

Highland Neurology

NYS Designated Stroke Center

NYS Dept of Health

Use the F.A.S.T. Test

If you think you or someone you know is having a stroke.

Face

Ask the person to smile. Is the face lopsided?

Arm

Ask the person to raise arms. Does one arm drift down?

Speech

Ask the person to repeat a phrase. Does their speech sound strange? Can they do it without slurring words?

Time

Don't waste it. Call 911 now.