Essential Tremor: What it is and how to treat it

August 1, 2012 Christopher Loiselle, MD


Do you or someone you know shake when raising a glass of water to drink or have problems writing a check at the grocery store?

If so, essential tremor may be the cause. Essential Tremor (ET) is the most common movement disorder and those suffering from it experience uncontrolled movement , usually of the hands and arms. Over 10 million Americans are diagnosed, yet many people have never heard of it. Some assume shaking is just a sign of aging or they fear they may have Parkinson’s disease. ET differs from Parkinson's in many ways, one being ET is an "action" tremor (more pronounced when trying to complete a task) where a person with Parkinson's has tremors more often at rest and the shaking may actually lessen during activity.

Essential Tremor is caused by overactive cells in the area of the brain called the thalamus. The thalamus is about the size of a walnut and within the brain there are two of them. If there are overactive cells in the right thalamus, the person will have signs of tremor on the left side and vice versa. Some patients suffer from tremor on both sides.

It is important to know Essential Tremor is a treatable condition.

There are three common methods of treatment:

  • Medication: Several medications are used with varying degrees of success. Once diagnosed, medications are usually prescribed first in hopes the patient will tolerate the dose and the tremor can be controlled. Drug therapy may lose effectiveness over time, at which point other options may be considered.
  • Deep Brain Stimulation (DBS): Is a surgical procedure and a great option for many people. Several tiny electrodes are implanted into the brain and a stimulator is attached to the wires under the skin near the collarbone. DBS provides nearly instantaneous relief from tremor in 80% of patients. You can click on this link and watch this short video to learn more about DBS, or watch footage from a DBS procedure that was livestreamed last year.

  • Gamma Knife Thalamotomy: Is a non-surgical treatment using highly focused radiation to kill the cells causing the tremor. Results take several months and like DBS has an 80% success rate.

Watch this video for more information about Gamma Knife:



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