Symptoms of Essential Tremor
What Are the Symptoms of Essential Tremor?
The primary symptoms associated with essential tremor include:
The primary symptoms associated with essential tremor include:
- Uncontrollable shaking that occurs for brief periods of time
- Shaking voice
- Nodding or shaking head
- Tremors that worsen during periods of emotional stress
- Tremors that get worse with purposeful movement
- Tremors that lessen with rest
- Balance problems
- Not able to write your name
If you have essential tremor, you will have shaking and trembling at different times and in different situations, but some characteristics are common to all. Here is what you might typically experience:
- Tremors occur when you move and are less noticeable when you rest.
- Tremors can begin in one hand and progress to both hands.
- Certain medicines, caffeine or stress can make your tremors worse.
- Tremors may improve with ingestion of a small amount of alcohol (such as wine).
- Tremors get worse as you age.
- Tremors that are most obvious in your hands.
- Difficulty doing tasks with your hands, such as writing or using tools.
- Shaking or quivering sound in your voice.
- Uncontrollable head-nodding, yes-yes or no-no motion of the head.
- In some instances, tremors in your legs or feet.
- Begin gradually, usually more prominently on one side of the body.
- May be aggravated by emotional stress, fatigue, caffeine, or temperature extremes.
Never heard of essential tremor?
Perhaps it's because so many other conditions compete for headlines. Advocates for people with ET have not had the benefit of a celebrity spokesperson such as Michael J. Fox or Muhammad Ali, who both have Parkinson's disease. The most famous person with ET was the late actress Katherine Hepburn, who parlayed her disorder into an intriguing component of both her vocal and on-screen personae. Other notables with ET include retired Supreme Court Justice Sandra Day O'Connor and the late West Virginia Senator Robert Byrd, who passed away last summer.
NOT THAT BAD—OR IS IT? Although the disease is not fatal, it can cause severe disability. “Essential tremor can cause significant disability. In addition, tremor tends to worsen with age.
Children & ET
Essential tremor (ET) is often thought of as an adult onset condition.
However, it can start any age and in early childhood affecting about 5% of children, predominantly involving the hands. There are two kinds of hand tremor, which are: Kinetic tremor only (i.e. tremor present only when the hands are moving) and Postural tremor only (i.e. tremor is visible when the hands are held outstretched) with some children experiencing both. The hand tremor leads to difficulty holding drinks, eating, writing, coloring, playing a musical instrument and sports.
Very little is known about the treatment of ET in childhood but it is helpful to be open about the condition, to discuss it and to have a common sense open approach. Children will often cope better than adults until school age when often a variety of problems such as writing, school meal times and comments from peers, may cause anxiety and embarrassment.
WHAT IS ESSENTIAL TREMOR? Essential tremor is a progressive neurologic condition that causes involuntary rhythmic trembling of the hands, head, tongue, voice, and less often the legs or trunk. Like Parkinson's disease, ET is considered a movement disorder. The disease is caused by abnormal communication—sometimes called a “misfire”—between certain areas of the brain including the cerebellum, thalamus, and brain stem.
Tremors may be more prominent when the person is highly active or anxious. A vicious circle can occur with ET: The person fears embarrassment in public, which in turn makes the tremor worse. As a result, people with ET may limit social interaction and even develop social phobia. Sometimes, observers assume the tremor is due to drug or alcohol intoxication.
“Essential tremor can cause significant disability. In addition, tremor tends to worsen with age.
COMMONLY MISDIAGNOSED
Essential tremor can be easily misdiagnosed as another movement disorder, most frequently Parkinson's disease. Essential tremor actually occurs eight times more often than Parkinson's. A handwriting test is often used to distinguish between the two, says Dr. Lyons. “Essential tremor often results in large, shaky handwriting samples. Parkinson's writing typically starts out normal, then gets smaller and smaller.”
Tremors of the voice and head also do not generally occur in Parkinson's but are commonly seen with ET. A patient suspected of ET should be examined while in a reclined or seated position with complete body support.
Dystonic tremor is also often confused with ET. Patients with dystonia exhibit an abnormal, involuntary spasm or contraction of muscles in the face, neck, hand, or torso. When muscles aren't used, they normally relax. With dystonia they do not, resulting in abnormal postures.
General neurologists treating tremor have a diagnostic error rate of 25 percent to 35 percent. “There is no laboratory test for ET, no biological marker to diagnose it.
Essential tremor vs. Parkinson's disease
Many people associate tremors with Parkinson's disease, but the two conditions differ in key ways:
Finding the right doctor for ET
Perhaps it's because so many other conditions compete for headlines. Advocates for people with ET have not had the benefit of a celebrity spokesperson such as Michael J. Fox or Muhammad Ali, who both have Parkinson's disease. The most famous person with ET was the late actress Katherine Hepburn, who parlayed her disorder into an intriguing component of both her vocal and on-screen personae. Other notables with ET include retired Supreme Court Justice Sandra Day O'Connor and the late West Virginia Senator Robert Byrd, who passed away last summer.
NOT THAT BAD—OR IS IT? Although the disease is not fatal, it can cause severe disability. “Essential tremor can cause significant disability. In addition, tremor tends to worsen with age.
Children & ET
Essential tremor (ET) is often thought of as an adult onset condition.
However, it can start any age and in early childhood affecting about 5% of children, predominantly involving the hands. There are two kinds of hand tremor, which are: Kinetic tremor only (i.e. tremor present only when the hands are moving) and Postural tremor only (i.e. tremor is visible when the hands are held outstretched) with some children experiencing both. The hand tremor leads to difficulty holding drinks, eating, writing, coloring, playing a musical instrument and sports.
Very little is known about the treatment of ET in childhood but it is helpful to be open about the condition, to discuss it and to have a common sense open approach. Children will often cope better than adults until school age when often a variety of problems such as writing, school meal times and comments from peers, may cause anxiety and embarrassment.
WHAT IS ESSENTIAL TREMOR? Essential tremor is a progressive neurologic condition that causes involuntary rhythmic trembling of the hands, head, tongue, voice, and less often the legs or trunk. Like Parkinson's disease, ET is considered a movement disorder. The disease is caused by abnormal communication—sometimes called a “misfire”—between certain areas of the brain including the cerebellum, thalamus, and brain stem.
Tremors may be more prominent when the person is highly active or anxious. A vicious circle can occur with ET: The person fears embarrassment in public, which in turn makes the tremor worse. As a result, people with ET may limit social interaction and even develop social phobia. Sometimes, observers assume the tremor is due to drug or alcohol intoxication.
“Essential tremor can cause significant disability. In addition, tremor tends to worsen with age.
COMMONLY MISDIAGNOSED
Essential tremor can be easily misdiagnosed as another movement disorder, most frequently Parkinson's disease. Essential tremor actually occurs eight times more often than Parkinson's. A handwriting test is often used to distinguish between the two, says Dr. Lyons. “Essential tremor often results in large, shaky handwriting samples. Parkinson's writing typically starts out normal, then gets smaller and smaller.”
Tremors of the voice and head also do not generally occur in Parkinson's but are commonly seen with ET. A patient suspected of ET should be examined while in a reclined or seated position with complete body support.
Dystonic tremor is also often confused with ET. Patients with dystonia exhibit an abnormal, involuntary spasm or contraction of muscles in the face, neck, hand, or torso. When muscles aren't used, they normally relax. With dystonia they do not, resulting in abnormal postures.
General neurologists treating tremor have a diagnostic error rate of 25 percent to 35 percent. “There is no laboratory test for ET, no biological marker to diagnose it.
Essential tremor vs. Parkinson's disease
Many people associate tremors with Parkinson's disease, but the two conditions differ in key ways:
- Timing of tremors. Essential tremor of the hands usually occurs when using the hands. Tremors from Parkinson's disease are most noticeable when the hands are at the sides of the body or resting in the lap.
- Associated conditions. Essential tremor doesn't cause other health problems, but Parkinson's disease is associated with stooped posture, slow movement and dragging the feet when walking. However, people with essential tremor sometimes develop other neurological signs and symptoms, such as an unsteady walk.
- Parts of the body affected. Essential tremor mainly involves the hands, head and voice. Parkinson's disease tremors usually start in the hands, and can affect the legs, chin and other parts of the body.
Finding the right doctor for ET
