Fact or Fiction: Understanding Essential Tremors
October 01, 2019
Anyone can have a tremor. Anxiety, excess caffeine, skipped meals, medications, alcohol, stress— can all cause slight tremors. However, according to Hooman Azmi, M.D., director of the Division of Functional and Restorative Neurosurgery at Hackensack Meridian Neuroscience Institute at Hackensack University Medical Center, some neurological disorders can also cause tremors.
“While shaky hands are often thought to be caused by Parkinson’s disease, one of the most common causes is essential tremor. Essential tremor is a neurological disorder that causes involuntary, rhythmic shaking. Nearly 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 your:
- Arms
- Head
- Legs
- Trunk
- Voice
“Head tremors can appear as the head shaking in a yes-yes, or no-no rhythm. Some may also have 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 cords 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 does not always mean you have Parkinson’s,” explains Umer Akbar, M.D., director of the Movement Disorders Center at Hackensack Meridian Neuroscience Institute at Hackensack University Medical Center. “It could be an essential tremor.”
“Parkinson’s disease is a generalized disorder with both motor and non-motor symptoms – some are related to movement, cognition, digestion or sleep. Many systems can be involved, presenting a variety of symptoms, and tremor is not always present,” says Dr. Akbar.
Some motor symptoms of Parkinson’s include:
- Impaired or slowed movement
- Stiffness in muscles
- Balance or gait issues
- Soft Speech
- Tremors
“With essential tremor, you may experience tremors, but not the other motor or nonmotor symptoms that go along with Parkinson’s,” shares Dr. Akbar.
The Cause of Essential Tremor is Unknown: FACT
“While there are some theories about what may cause essential tremor, the exact nature of what brings it about is still unknown and it is not a condition you can actively prevent,” says Dr. Azmi.
According to Dr. Azmi, family history may play a role in essential tremor. “Essential tremor may run in families. While it can spontaneously occur for some, a child has a higher chance of inheriting the condition if the parent has an essential tremor,” he adds.
Essential tremor can occur at any age but typically present around ages 40 to 50.
Surgery is Not a Treatment Option to Manage an Essential Tremor: FICTION
There are some surgical and non-surgical options. “Treatment options can include a few different medications and even Botox injections,” shares Dr. Azmi.
Focused ultrasound (FUS) is a minimally invasive alternative to surgery that has proven to be very effective in reducing tremors. The procedure uses sound waves to target the areas of the brain that cause tremors. FUS can help improve quality of life by helping with everyday activities such as eating and drinking.
There are also surgical procedures to treat tremors, however, If you have a mild tremor that doesn’t bother you or disrupt your daily life, surgery is probably not the best option.
“Deep brain stimulation (DBS) is another form of surgical treatment, and it works exceptionally well to reduce a tremor. But remember, DBS is brain surgery, so the benefits have to outweigh the risks,” he adds.
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 be temporarily improved,” shares Dr. Azmi.
“We certainly don’t advise patients to start drinking to stop their tremors. 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. While it may reduce the presence of tremors at the moment, people may notice rebound tremors once the alcohol has passed through the body.
Anxiety or Caffeine Can Make Tremors Worse: FACT
“Anxiety or products with caffeine can worsen or trigger tremors. For example, if someone is in a situation that’s making them anxious, their tremor can become more pronounced,” shares Dr. Akbar.
“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 associated with another condition like Parkinson’s, your neurologist will work with you to determine the best treatment plan to help minimize your symptoms,” adds Dr. Akbar.
Next Steps & Resources
- Meet our experts: Hooman Azmi, M.D,, Umer Akbar, M.D.
- To make an appointment with Dr. Azmi or a doctor near you, call 800-822-8905 or visit our website.
- Learn more about neuroscience at Hackensack Meridian Health.
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.
