BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuEssential tremorTremor - essential; Familial tremor; Tremor - familial; Benign essential tremor; Shaking - essential tremorEssential tremor (ET) is a type of involuntary shaking movement. It has no identified cause. Involuntary means you shake without trying to do so and are not able to stop the shaking at will. Causes ET is the most common type of tremor. Everyone has some tremor, but the movements are often so small that they can't be seen. ET affects both men and women. It is most common in people older than 65 years.The exact cause of ET is unknown. Research suggests that the part of the brain that controls muscle movements does not work correctly in people with ET.If an ET occurs in more than one member of a family, it is called a familial tremor. This type of ET is passed down through families (inherited). This suggests that genes play a role in its cause.Familial tremor is usually a dominant trait. This means that you only need to get the gene from one parent to develop the tremor. It often starts in early middle age, but may be seen in people who are older or younger, or even in children. Symptoms The tremor is more likely to be noticed in the forearm and hands. The arms, head, eyelids, or other muscles may also be affected. The tremor rarely occurs in the legs or feet. A person with ET may have trouble holding or using small objects such as silverware or a pen.The shaking most often involves small, rapid movements occurring 4 to 12 times a second.Specific symptoms may include:Head nodding Shaking or quivering sound to the voice if the tremor affects the voice box Problems with writing, drawing, drinking from a cup, or using tools if the tremor affects the handsThe tremors may:Occur during movement (action-related tremor) and may be less noticeable with rest Come and go, but often get worse with age Worsen with stress, caffeine, lack of sleep, and certain medicines Not affect both sides of the body the same way Improve slightly by drinking a small amount of alcohol Exams and Tests Your health care provider can make the diagnosis by performing a physical exam and asking about your medical and personal history.Tests may be needed to rule out other reasons for the tremors such as:Smoking and smokeless tobacco Overactive thyroid (hyperthyroidism) HyperthyroidismHyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often called overactive thyroid.ImageRead Article Now Book Mark Article Suddenly stopping alcohol after drinking a lot for a long time (alcohol withdrawal) Alcohol withdrawalAlcohol withdrawal refers to symptoms that may occur when a person who has been drinking too much alcohol on a regular basis suddenly stops drinking ...Read Article Now Book Mark Article Too much caffeine Use of certain medicines Nervousness or anxietyBlood tests and imaging studies (such as a CT scan of the head, brain MRI, and x-rays) are usually normal.MRIA magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...ImageRead Article Now Book Mark Article x-raysX-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray particles through the body. The im...ImageRead Article Now Book Mark Article Treatment Treatment may not be needed unless the tremors interfere with your daily activities or cause embarrassment.HOME CAREHOME CAREA tremor is a type of shaking in your body. Most tremors are in the hands and arms. However, they may affect any body part, even your head or voice...Read Article Now Book Mark Article For tremors made worse by stress, try techniques that help you relax. For tremors of any cause, avoid caffeine and get enough sleep.For tremors caused or made worse by a medicine, talk to your provider about stopping the medicine, reducing the dosage, or switching. Do not change or stop any medicine on your own.Severe tremors make it harder to do daily activities. You may need help with these activities. Things that can help include:Buying clothes with Velcro fasteners, or using button hooks Cooking or eating with utensils that have a larger handle Using straws to drink Wearing slip-on shoes and using shoehorns MEDICINES FOR TREMORMedicines may help relieve symptoms. The most commonly used drugs include:Propranolol, a beta blocker Primidone, a drug used to treat seizures These drugs can have side effects.Propranolol may cause fatigue, stuffy nose, or slow heartbeat, and it may make asthma worse. Primidone may cause drowsiness, problems concentrating, nausea, and problems with walking, balance, and coordination. Other medicines that may reduce tremors include:Antiseizure medicines Mild tranquilizers Blood pressure medicines called calcium-channel blockers Botox injections given in the hand may be tried to reduce tremors.SURGERYIn severe cases, surgery may be tried. This may include:Focusing high-powered x-rays on a small area of the brain (stereotactic radiosurgery) Stereotactic radiosurgeryStereotactic radiosurgery (SRS) is a form of radiation therapy that focuses high-power energy on a small area of the body. Despite its name, radiosur...Read Article Now Book Mark Article Implanting a stimulating device in the brain to signal the area that controls movement Outlook (Prognosis) An ET is not a dangerous problem. But some people find the tremors annoying and embarrassing. In some cases, it may be dramatic enough to interfere with work, writing, eating, or drinking. Possible Complications Sometimes, the tremors affect the vocal cords, which may lead to speech problems. When to Contact a Medical Professional Call your provider if:You have a new tremor Your tremor makes it hard to perform daily activities You have side effects from the medicines used to treat your tremor Prevention Alcoholic beverages in small quantities may decrease tremors. But alcohol use disorder may develop, especially if you have a family history of such problems.Open ReferencesReferencesBhatia KP, Bain P, Bajaj N, et al. Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord. 2018;33(1):75-87. PMID: 29193359 pubmed.ncbi.nlm.nih.gov/29193359/.Hariz M, Blomstedt P. Surgical management of tremor. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 87.Jankovic J. Parkinson disease and other movement disorders. In: Daroff RB, Jankovic J, Maziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 96.Okun MS, Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 382.AllVideoImagesTogCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.Central nervous system and peripheral nervous systemillustrationCentral nervous system and peripheral nervous system - illustration The central nervous system comprises the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.Central nervous system and peripheral nervous systemillustrationSelf Care Tremor - self-careRelated Information Benign(Special Topic) Review Date: 6/23/2020 Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.