Essential Tremor: A Treatable Tremor

Thursday, September 16, 2010

ROCHESTER, Minn. — A trembling hand may be the first sign of essential tremor. The September issue of Mayo Clinic Women's HealthSource covers essential tremor, which affects an estimated 10 million Americans.

Essential tremor most often involves hands that tremble while performing a task such as lifting a utensil or a cup. This neurological condition may also cause the head to move side to side or up and down and may give the voice a shaky quality. Essential tremor typically doesn't become a problem until middle age or later. It isn't life threatening. Symptoms can be embarrassing and, in some cases, disabling.

Essential tremor is believed to be caused by genetics but researchers haven't yet identified the genes that might be responsible. Just over half of those with essential tremor have or had an immediate family member with the condition. Essential tremor is not associated with Parkinson's disease, a progressive disease caused by damage to structures within the brain.

No treatment may be needed when symptoms are mild. Getting plenty of rest and minimizing stress can help reduce symptoms. Several medications can be considered when symptoms are troublesome. A beta blocker called propranolol (Inderal) is used most often. Other beta blockers as well as some anti-seizure medications are options, too.

When medications don't help enough, deep brain stimulation may be considered. "In this procedure, a wire, or stimulating electrode is inserted into the area of the brain call the thalamus," explains J. Eric Ahlskog, M.D., Ph.D., a Mayo Clinic neurologist. "This is connected to a pacemaker-like device that's implanted under the skin, just below the collarbone."

The device transmits electrical impulses that interrupt the tremors. Deep brain stimulation requires major surgery so it's not considered unless symptoms are disabling.

Mayo Clinic Women's HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9751, (toll-free) or visit Mayo Clinic's Online Bookstore.

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