OnabotulinumtoxinA (Botox) injections for Essential Tremor

​Botulinum toxin (Botox) injections provide a highly targeted, temporary treatment to reduce the severity of Essential Tremors.

​While traditionally used for aesthetic reasons, Botox blocks the chemical signals that cause involuntary muscle contractions, helping to calm the overactive muscles driving the shakes. It serves as a valuable mid-level option for patients who do not respond well to oral medications—like beta-blockers or primidone—but wish to avoid invasive brain surgeries

How Botox Works for Tremors

• Targeted relaxation: Injections block chemical signals that cause involuntary muscle contractions.

• Duration: Benefits typically appear within 1 to 2 weeks, peak at one month, and wear off around 12 weeks, requiring repeat treatments.

• Precision: Advanced techniques using electromyography (EMG) or ultrasound help pinpoint the correct forearm or neck muscles to maximize control and limit side effects. 

Potential Side Effects

• Local weakness: Temporary weakness in the injected fingers, hand, or neck muscles is the most common risk.

• Dose dependency: Higher doses increase the chance of unintended muscle relaxation, making customized dosing by a movement disorder specialist essential. ​

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​* However, if Botox is used to treat hand tremors, it can cause weakness in your fingers. If it's used to treat voice tremors, it can cause a hoarse voice and difficulty swallowing.