Fact or Fiction: Understanding Essential Tremors   
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Fact or Fiction: Understanding Essential Tremors

By Katie Lynch

Any person can have a tremor. Anxiety, excess caffeine, skipped meals, medications, alcohol, stress— these are all things that can cause a slight shake of the hands. However, there are also a number of neurological disorders that can also cause a tremor according to neurosurgeon, Hooman Azmi, M.D.

“Shaky hands may often be mistaken for Parkinson’s disease; however, one of the most common causes is essential tremors. Essential tremor is a neurological disorder that causes involuntary, rhythmic shaking. It’s estimated that 10 million people in the U.S. suffer from an essential tremor,” shares Dr. Azmi, who helps us separate the facts and fiction of essential tremor.

An essential tremor only presents as hand shaking: FICTION

While tremors most commonly affect the hands, they can also affect the head, voice, arms, tongue, legs or even trunk.

“Head tremors can appear as the head shaking in a yes-yes, or no-no rhythm. Some may have a spasmodic dysphonia, a voice tremor,” shares Dr. Azmi. “If you’ve heard this once, it’s easy to recognize – there’s a shaking of the larynx and vocal chords affecting the voice. A person’s voice may be shaking, and have a see-saw quality.”

If you have a tremor, you have Parkinson’s disease: FICTION

“A tremor can be a symptom of Parkinson’s disease, however, it does not mean that you have Parkinson’s,” explains Dr. Azmi. “It could be an essential tremor.”

“Parkinson’s disease is essentially a head-to-toe disorder with both motor and non-motor symptoms – some are related to movement, cognition, emotions or sleep. Many systems can be involved, presenting in a variety of symptoms, and you may or may not have a tremor,” says Dr. Azmi. “Symptoms of Parkinson’s include tremors, slowed or impaired movement, speech changes, and gait or balance problems.”

“With essential tremors, you may experience tremors, but not all of the other symptoms that go along with Parkinson’s.”

The cause of essential tremors is unknown: FACT

“Unfortunately, since the cause of essential tremors is unknown, it’s not something you can actively prevent,” says Dr. Azmi.

“Essential tremor may run in families. While it can spontaneously occur for some, a child has about a 50% chance of inheriting the condition if the parent has an essential tremor,” he adds.

Essential tremors can occur at any age, but typically present around ages 40 to 50.

Surgery is a routine treatment option to manage an essential tremor: FICTION

“Treatment options can include a variety of medications, including some blood pressure medicines, beta blocker medications, or even Botox,” shares Dr. Azmi.

“Deep brain stimulation (DBS) is a surgical form of treatment, and it works exceptionally well to reduce or even eliminate a tremor. But remember, DBS is brain surgery, so the benefits have to outweigh the risks,” he adds.

If you have a mild tremor, and it doesn’t bother you or disrupt your daily living, then surgery probably isn’t the best option.

A glass of wine can help reduce the presence of a tremor: FACT

“Interestingly, essential tremor is often reduced by alcohol. So if you have a glass of wine, the tremor may temporarily go away or be significantly reduced,” shares Dr. Azmi.

“We certainly don’t advise patients to start drinking, however it can help us to distinguish what type of tremor they might have. Alcohol can reduce essential tremors, but it typically does nothing for Parkinson’s-related tremors.”

Alcohol is not a recommended treatment option, and while it may reduce the presence of a tremor in the moment, patients should be aware of rebound tremors once the alcohol has passed through the body.

Anxiety or caffeine can make tremors worse: FACT

“Anxiety or anything with caffeine can certainly make tremors worst. For example, if someone has an essential tremor, and they are in a situation that’s making them anxious, their tremor can become more pronounced,” shares Dr. Azmi.

“It’s very important to consult a movement disorder specialist if you notice a tremor so they can determine the cause. If it’s an essential tremor, or if it’s associated with another condition like Parkinson’s, your neurologist will work with you to determine if a treatment plan is needed to help minimize your symptoms,” adds Dr. Azmi.

Dr. Azmi, a board-certified neurosurgeon, specializes in the surgical treatment of Parkinson’s disease and other movement disorders. He is the director of the Division of Movement Disorders at Hackensack University Medical Center. To make an appointment, call 201-342-2550. To find a provider near you, please visit HackensackMeridianHealth.org.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.


National Institute of Neurological Disorders and Stroke


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