Essential Tremor

Authored by MCN Neurologists



Essential tremor (ET) is a common neurological condition that causes involuntary tremors (shaking) in the hands, legs, trunk, head or voice.


ET involves rhythmic shaking of the body.  It can be frustrating or socially embarrassing.  In some cases, it can interfere with daily tasks, such as handwriting, eating, drinking or tasks requiring fine motor coordination.  Sometimes, the voice can be affected.  ET can affect people of any age.


No cause has been determined for ET.  Often it tends to happen to members of the same family, indicating that there is a genetic relationship in those cases.  However, there are many people with ET in which there is no family history of tremor.

Examination and Tests

There are no medical tests that specifically diagnose ET.  It is diagnosed during the neurological evaluation through a review of symptoms and physical examination.  The neurologist will need to exclude medication side effects, thyroid disease, excessive stress or anxiety, excessive use of caffeine and other movement disorders, such as Parkinson’s disease.


Patients should work closely with their doctor to find the most effective treatment for ET.  Often several treatments need to be attempted before the best option is determined.  If the tremor is mild and not bothersome, patients do not need treatment.  If it interferes with the ability to work, perform daily tasks or social activities, medical therapy should be considered.

There is currently no cure for ET.  Medications can be effective in reducing tremor for at least half of patients with ET.  Medications that might be considered include beta-blockers (propranolol, atenolol, metoprolol and nadolol), primidone or benzodiazepines.  In special circumstances, other less commonly used medications, or botulinum toxin injections, might be considered. Rarely, if medical treatment is not successful and the tremor causes serious disability, surgical alternatives, such as deep brain stimulation, might be an option.  Some people have found occupational and physical therapy helpful for managing some of the symptoms of ET.  Treatment suggestions might also include using heavier utensils, cups and glasses, wrist weights, larger writing instruments and other adaptive devices.

For further information about essential tremor, click on the following link: (International Essential Tremor Foundation) (National Institute of Neurological Disorders and Stroke)

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