When patients or their loved ones notice a tremor, the first concern is a serious neurologic condition. However, essential tremor, also occasionally known as physiologic tremor or familial tremor, is the most common movement disorder, affecting approximately one in every twenty people worldwide. While it most commonly involves the hands, a tremor can affect the face, the legs, the voice, or the trunk. It is most often caused by a genetic mutation but can sometimes occur without one even if the brain looks completely normal on imaging.
A skilled neurologist can usually differentiate an essential tremor from a more serious cause of tremor such as Parkinson disease on the basis of history and physical examination. Therefore, if you notice a tremor, it is important to have a neurologist assess it. Essential tremor, while not a life-threatening condition, can interfere with your ability to do anything with the body parts involved.
Many gene mutations that can cause essential tremor can run in families. Children of patients who have essential tremor are more likely to also have it, though this is not always the case.
Tremor can be diagnosed by a neurologist after a thorough physical and neurological examination. Your neurologist will also gather your detailed medical history and check other neurological findings. Additional tests may be ordered depending on the complexity of the condition, to include an EMG to diagnose muscle or nerve problems.
Occupational therapy can often be helpful as a first step in helping patients learn strategies to work around their tremors. If the tremors continue to be a problem, there are several medication options available to try. Patients who continue continue to have difficulty with day-to-day tasks despite high doses of these medications may be candidates for deep brain stimulation, a surgery in which a pacemaker-like device is introduced into the brain to regulate the electric signals in parts of the brain involved in generating the tremor.