What Are Essential Tremors?

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One of the most popular songs of 2015 is Taylor Swift’s “Shake It Off.” That song carries a positive message, but it is an ironic one for the more than 10 million people all over the world who are living with an uncontrollable shaking disorder called Essential Tremor. Essential Tremor, or ET, is a neurological disorder that impacts body movement, causing rhythmic shaking. The areas most frequently affected are hands, arms, and head, but it can also affect areas such as the vocal cords.

ET is often confused with Parkinson’s Disease, which is better known. The shaking is similar in nature, but they are very different disorders, in that ET patients experience specific neurological deficits.

Approximately 50 percent of cases of ET result from a genetic mutation, but the cause is unknown. Scientists have learned which areas of the brain are involved, but much remains undiscovered.

Because ET makes daily living so difficult, many patients with Essential Tremor experience depression and anxiety.
Occupational therapists have helped patients develop some simple coping mechanisms, such as:

Drink with a cup with a lid and straw.
When eating out, ask that cups be filled only halfway.
Write on a soft surface to make handwriting more legible.
Avoid caffeine and other substances that may increase heart rate and temporarily increase tremors.
Complete any forms, checks, or envelopes at home.
Use a signature stamp or address labels rather than writing it every time.
Use an electric toothbrush over a traditional toothbrush.

Essential Tremor (and other shaking disorders) are so common that many types of assistive devices have been developed to help with tasks such as dressing and eating. Some of these are swivel silverware that always stay upright, and shirts with magnetic buttons or Velcro.

Computer apps have also been developed to help with technology. These include text-to-speech keyboards, a specialized mouse to reduce errors, and an extra-large keyboard.

If you suffer from ET, it is important to know you are not alone. A number of famous people have had ET, including the actress Katherine Hepburn.

To determine whether you have ET or Parkinson’s Disease involves getting a DatScan, a single-photon emission computed tomography (SPECT) imaging scan that uses a drug called Ioflupane. This is a radioactive iodine substance that images dopamine transporters in the brain, which will provide an accurate diagnosis.

If your tremors are mild, treatment may not be necessary. But if ET is interfering with your regular activities, medications can provide relief. Sixty percent of ET patients respond to medication, which can include beta blockers, anti-seizure medications, or Botox injections into the muscles of the head and vocal cords. Surgery may also be an option. In some cases of ET, a surgeon will insert a thin electrical probe into the part of the brain that controls the tremors, to interrupt the process.

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