Essential tremor is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you do simple tasks, such as drinking from a glass or tying shoelaces.
Essential tremor is usually not a dangerous condition, but it typically worsens over time and can be severe in some people. Other conditions don't cause essential tremor, although essential tremor is sometimes confused with Parkinson's disease.
Essential tremor can occur at any age but is most common in people age 40 and older.
Essential tremor signs and symptoms:
- Begin gradually, usually more prominently on one side of the body
- Worsen with movement
- Usually occur in the hands first, affecting one hand or both hands
- Can include a "yes-yes" or "no-no" motion of the head
- May be aggravated by emotional stress, fatigue, caffeine or temperature extremes
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 you use your hands. Tremors from Parkinson's disease are most prominent when your hands are at your sides or resting in your lap.
- Associated conditions. Essential tremor doesn't cause other health problems, but Parkinson's disease is associated with stooped posture, slow movement and shuffling gait. However, people with essential tremor sometimes develop other neurological signs and symptoms, such as an unsteady gait (ataxia).
- Parts of body affected. Essential tremor mainly involves your hands, head and voice. Parkinson's disease tremors usually start in your hands, and can affect your legs, chin and other parts of your body.
About half of essential tremor cases appear to result from a genetic mutation. This form is referred to as familial tremor. It isn't clear what causes essential tremor in people without a known genetic mutation.
Autosomal dominant inheritance pattern
In an autosomal dominant disorder, the mutated gene is a dominant gene located on one of the nonsex chromosomes (autosomes). You need only one mutated gene to be affected by this type of disorder. A person with an autosomal dominant disorder — in this case, the father — has a 50% chance of having an affected child with one mutated gene (dominant gene) and a 50% chance of having an unaffected child with two normal genes (recessive genes).
Known risk factors for essential tremor include:
Genetic mutation. The inherited variety of essential tremor (familial tremor) is an autosomal dominant disorder. A defective gene from just one parent is needed to pass on the condition.
If you have a parent with a genetic mutation for essential tremor, you have a 50 percent chance of developing the disorder yourself.
- Age. Essential tremor is more common in people age 40 and older.
Essential tremor isn't life-threatening, but symptoms often worsen over time. If the tremors become severe, you might find it difficult to:
- Hold a cup or glass without spilling
- Eat normally
- Put on makeup or shave
- Talk, if your voice box or tongue is affected
- Write legibly
Essential tremor care at Mayo Clinic
Jan. 23, 2019
- NINDS essential tremor information page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Essential-Tremor-Information-Page. Accessed Nov. 30, 2018.
- Facts about essential tremor. International Essential Tremor Foundation. http://www.essentialtremor.org/free-downloads/. Accessed Nov. 30, 2018.
- Tarsy D. Surgical treatment of essential tremor. https://www.uptodate.com/contents/search. Accessed Nov. 22, 2015.
- Tarsy D. Overview of tremor. https://www.uptodate.com/contents/search. Accessed Nov. 12, 2015.
- National Library of Medicine. What is essential tremor? Genetics Home Reference. http://ghr.nlm.nih.gov/condition/essential-tremor/. Accessed Nov. 30, 2018.
- Tarsy D. Pharmacologic treatment of essential tremor. https://www.uptodate.com/contents/search. Accessed Nov. 12, 2015.
- Essential tremor (ET) patient handbook. International Essential Tremor Foundation. http://www.essentialtremor.org/free-downloads/. Accessed Nov. 30, 2018.
- Essential tremor (ET) coping tips for everyday living. International Essential Tremor Foundation. http://www.essentialtremor.org/free-downloads/. Accessed Nov. 30, 2018.
- AskMayoExpert. Essential tremor (adult). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018.
- Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Oct. 17, 2018.
- Essential tremor (ET) surgical options. International Essential Tremor Foundation. https://www.essentialtremor.org/free-downloads/. Accessed Dec. 7, 2018.
- Schaink A, et al. Magnetic resonance-guided focused ultrasound neurosurgery for essential tremor: A health technology assessment. Ontario Health Technology Assessment Series. 2018;18:1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963668/. Accessed Dec. 11, 2018.