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Essential tremor is the most common cause of shaking, and usually affects your hands first.

Essential tremor is the most common cause of shaking, and usually affects your hands first.
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Essential tremor

3-minute read

What is essential tremor?

Essential tremor is a condition that affects the nerves and causes uncontrollable shaking, or tremor. It is the most common cause of shaking, and usually affects the hands first.

What are the symptoms of essential tremor?

The most common symptom is shaking of the hands — usually when they’re being used. With Parkinson’s disease, however, the hands usually shake when they are resting. The head, arms, jaw, tongue and legs can also be affected. Some people develop a shaky voice.

Having an essential tremor affects different people in different ways. Some people find it largely doesn’t bother them. Some people find the symptoms embarrassing. Some find them upsetting. Some people find they have trouble with things like drinking a cup of coffee. A few people find it inhibits their way or life. There are no rules about how an essential tremor affects people.

What causes essential tremor?

It seems that essential tremor is caused by a minor problem deep inside the brain. But it is not clear why this happens. Essential tremor doesn’t cause any other conditions such as Parkinson’s disease, nor is it caused by other conditions.

You have a 1 in 2 chance of inheriting essential tremor if one of your parents has it. It is also more common in older people, but it can begin at any age.

How is essential tremor diagnosed?

There are no special tests for diagnosing essential tremor. Your doctor will usually make a diagnosis after asking you about your medical history and your symptoms. They may also do a full physical exam and arrange for blood tests to try and rule out other possible causes of shaking.

How is essential tremor treated?

If you have essential tremor, you might find there are things that make it worse, such as stress, caffeine, alcohol and some medicines such as asthma medicines, Ritalin or lithium. Avoiding these triggers can help.

If needed, your doctor might prescribe medicine to decrease the tremor. Possible medicines include:

  • beta blockers — propranolol is the most commonly prescribed of the beta blockers, which are widely used to lower blood pressure
  • anti-epileptic medicines such as primidone and gabapentin
  • muscle relaxants such as alprazolam

Your doctor might suggest surgery if you are among the few people who have severe shaking despite avoiding triggers and taking prescribed medicines. Surgery to treat essential tremor may involve stimulation of an area in the brain called the thalamus and this procedure is known as ‘deep brain stimulation’.

If you notice that your hands shake and you don’t know why, make sure that you talk to your doctor to get the right diagnosis and treatment.

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Last reviewed: July 2020

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