Essential tremor can be caused by unusual electrical activity in the brain that sends faulty messages to the muscles. People usually experience essential tremor in middle age. Tremors can become more severe as you get older, or due to certain medications, stress, exhaustion, low blood sugar or even a fever.

Genetics may also play a role; a child who has a parent with this condition has a 50 percent higher chance of developing essential tremor.

Essential tremor often appears in adolescence or middle age (between ages 40 to 50) and tends to initially affect your hands while you’re using them, rather than when they’re at rest.

Other essential tremor symptoms include: 

• Difficulty writing or drawing; 
• Shaking, trembling hands that make it difficult to eat or hold objects; 
• Tremors that are more noticeable on your dominant side and less noticeable when your hands are resting;
• A shaky voice;
• More intense shaking/tremors after ingesting caffeine or when stressed; 
• Less intense tremors after drinking small amounts of alcohol;

Involuntary nodding (“yes”) or shaking (“no”) of the head.

A Hackensack Meridian Health neurologist will perform a series of tests to diagnose essential tremor and to rule out other conditions that might cause your tremors, such as a hyperactive thyroid, a medication you’re taking or a neurological disorder such as multiple sclerosis or stroke. 

After reviewing your symptoms and medical history and performing a physical exam, a movement disorder specialist may conduct the following to potentially diagnose you with essential tremor: 

• Perform lab tests, such as by collecting blood and urine samples; 
• Conduct physical tests, such as watching you drink from a glass, write a word or draw a shape;
• Assess your cognitive function, such as memory, attention and language skills with a neuropsychological exam;
• Perform an electromyography (EMG) to measure the electrical impulses of your nerves and muscles;
• Perform computed tomography (CT), magnetic resonance imaging (MRI) and other imaging tests to look for neurological abnormalities;
• Conduct a neurophysiological exam using visual, electrical and other types of stimulation to detect neurological abnormalities.

Essential tremor can be a symptom of Parkinson’s disease, however, someone with essential tremor does not always have Parkinson’s disease. The two conditions differ in many ways, such as:

• Essential tremor is eight times more common than Parkinson’s disease.
• Parkinson’s disease tremors generally begin around age 60 and often on one side of the body. Essential tremor can begin in adolescence or around age 40 or 50 and initially affects both sides of the body.
• Parkinson’s disease tremors usually occur at rest. Essential tremors usually occur during movement. 
• Essential tremor has a closer connection to genetic causes than Parkinson’s disease. 
• Parkinson’s disease is essentially a “head-to-toe” neurological disorder that affects many parts of the body, causing stiff muscles, slow movement, balance issues and stooped posture. Essential tremor typically involves shaking in the upper half of the body only. 
• A glass of wine can temporarily reduce essential tremors and trembling, but does nothing for tremors related to Parkinson’s. (Note: Alcohol is not a recommended treatment for essential tremor, as it can lead to rebound tremors once the alcohol passes through the body.)