Essential tremor

Introduction 

Essential tremor (ET) is a type of uncontrollable shake or tremble of part or parts of the body.

Most people who suffer from essential tremor experience a trembling, up-and-down movement of the hands.  However, the arms, head, eyelids, lips and other muscles can also be affected. A tremor in the voice box (larynx) may cause a shaky voice.

Managing stressful feelings and stressful situations is a life skill which is a challenge for all of us, but it’s especially important if you struggle with essential tremor. While medication and changes to your lifestyle can help keep the symptoms under check, stress, in particular, can easily aggravate the condition.

 

On first sight, essential tremor can resemble Parkinson’s disease. But you can tell the two conditions apart because essential tremor is usually more noticeable when you're trying to hold a position or do something with your hands, such as write, eat or drink. It doesn't always affect both sides of the body equally. On the other hand, there is a tendency for tremors from Parkinson’s to affect you when you’re still.  However, it’s important to note that people with essential tremor also can have tremors when their hands are at rest. Also, some people with Parkinson’s disease do not have tremor, so it is important to see a neurologist for accurate diagnosis.

 

Essential tremor is a common movement disorder affecting around 4% of adults over 40 years of age. People most often will first notice symptoms either in their 20s – or not until later in their 60s. Some people only have a mild tremor at first, which usually gets more severe as they get older. A small number of people who suffer from essential tremor can have balance problems.

'Normal' tremor

Everyone has a very minor tremor when carrying out daily activities. For example, your hands will shake slightly when you hold them out in front of you. This is common.

Sometimes, the everyday level of tremor can become more noticeable, particularly in older people. Noticeable tremor is also normal and it's often caused by a raised level of adrenaline, which can happen when a person is stressed, anxious or angry.

When does a tremor become an issue?

Essential tremor is more severe than normal tremor and it usually gets worse gradually over time. Eventually, the tremor may become so severe that carrying out normal, everyday activities can become a challenge.

Certain things may temporarily increase any tremor, including:

  • tiredness caused by strenuous activity or lack of sleep

  • Stress

  • smoking

  • caffeine – from tea, coffee, chocolate and some fizzy drinks

  • being very hot or cold

  • taking certain medications – including some antidepressantslithium and treatments for asthma.

When to seek medical help

It's important to visit your GP if you experience frequent or severe tremors.

Although there's no specific test to diagnose essential tremor, your GP can carry out a physical examination and may request further tests to rule out other conditions (see causes, below).

They'll also ask about your personal and family medical history as part of their assessment and also refer you to a consulting neurologist.

 

Treating essential tremor

Currently there's no cure for essential tremor, but medicines can be used to help improve the symptoms in at least half of people with the condition.

In rare cases, a severe tremor may be treated with surgery if it doesn't respond to medication.

Read more about treating essential tremor.

Inherited essential tremor

Essential tremor can run in families and research suggests it's passed on by a faulty gene. At least half of people with the condition have a family member who also has it. 

Nonetheless, the age at which a tremor develops and its severity can differ significantly between different family members. Some people may also develop the faulty gene without inheriting it from either parent.

 

Other causes of tremor

There are a number of conditions which may cause tremor, including:

  • overactive thyroid (hyperthyroidism)

  • Parkinson's disease, a long-term condition affecting the way the brain co-ordinates body movements

  • multiple sclerosis, a condition of the central nervous system (brain and spinal cord) affecting the senses and the body's actions

  • dystonia, a range of movement disorders which cause involuntary muscle spasms

  • stroke, which very rarely may result in tremor with few other symptoms

  • Kidney and liver disease

  • peripheral neuropathy, where the peripheral nervous system is damaged

A tremor can also be one of the withdrawal symptoms for people who are alcoholic and have stopped or reduced their alcohol intake.

What is DaTscan® and how can it help me?

DaTscan® is a neuroimaging tool (brain scan) that can assist in differentiating essential tremor and Parkinson’s disease, but it does not provide a definitive diagnosis for either disease. In cases where neurological examination is not sufficient to make a diagnosis of either essential tremor or Parkinson’s disease, DaTscan may be helpful.

PD is related to a decrease in a chemical in the brain called dopamine. DaTscan® involves a picture of the brain using single photon emission computed tomography (SPECT), to measure dopamine transporter levels in the brain. In Parkinson’s disease, an abnormal scan representing a reduction in dopamine transporter levels is seen, whereas in essential tremor the scan is normal.

 

Conclusion

Although science based evidence that supports nutritional solutions for essential tremor is scant at best, my own experience with tremor patients who followed my professional support has been quite successful in the majority of cases where clients followed a sustainable programme which included stress management, physical exercise and most importantly a customised diet.

If you have any questions or require my support please don’t hesitate to contact me.

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