Essential Tremor

Symptoms

Essential tremor can begin with an up-and-down shaking of the hand that is barely noticeable at first and sometimes first appears in the teen years, goes into remission for decades, and surfaces again late in adulthood. More often, however, initial onset is not until middle age or later.

Many patients associate their tremor with a stressful event such as an accident or the death of a loved one. Although not a cause of essential tremor, stress may increase it.

The shaking worsens when basic movements are attempted, such as holding a cup of coffee, writing or using a knife and fork. Fine motor movements, such as using utensils or small tools, may be particularly difficult.

In time, the problem may affect the arm or both arms. The head or chin may be affected as well, as may (less commonly) the tongue, larynx or eyelids.

Anxiety aggravates the tremor and trying to stop it only makes it worse. Symptoms can fluctuate by the hour or over longer periods. Temperature extremes may also worsen the condition.

The tremor does not occur during sleep.