Benign Essential Tremor

Benign essential tremor (ET) is a movement disorder most commonly noticed by shaking in the hands. It occurs in about 5% of older adults. It may also cause shaking of the head, voice, arms, and trunk. It occurs less often in the legs and feet. Two types of tremor are common with ET: ET can be socially isolating in some cases. It may interfere with normal daily activities such as writing or speaking.

  • Causes

    For some people, ET is caused by a genetic mutation. For others, the cause is not clear.

  • Definition

    Benign essential tremor (ET) is a movement disorder most commonly noticed by shaking in the hands. It occurs in about 5% of older adults. It may also cause shaking of the head, voice, arms, and trunk. It occurs less often in the legs and feet. Two types of tremor are common with ET:

    • Postural tremor—shaking in certain positions only, such as with arms outstretched
    • Kinetic or action tremor—shaking that gets worse during activities, such as eating or shaving

    ET can be socially isolating in some cases. It may interfere with normal daily activities such as writing or speaking.

  • Diagnosis

    You will be asked about your symptoms and your medical and family history. A physical exam will be done. Attention will be paid to the central nervous system. There are no special tests to diagnose ET.

  • Prevention

    There is no known way to prevent ET.

  • Risk Factors

    Family history of tremors is the only known risk factor for ET. The condition may occur at any age. It is more likely to occur in teens and people older than 50 years old.

  • Symptoms

    ET is generally not serious, but its severity may vary and worsen over time. Symptoms may include:

    • Tremor that occurs when standing or moving the limbs, but not usually at rest
    • Uncontrollable, rhythmic movement
    • Shaking most common in hands, arms, head, or voice
    • Shaking only in certain positions or during activity
    • Trouble with fine motor skills such as drawing, sewing, or playing an instrument
    • Shaking that gets worse from caffeine, stress, fatigue, or heat
    • Shaking that may decrease when using alcohol
    • Hearing loss
    • Problems with social, functional, or job-related abilities in more severe cases

    Tremors must not be related to other health conditions in order for someone to have the ET diagnosis.

  • Treatment

    Most people with ET do not require treatment. Mild tremors may be relieved or even eliminated by simple measures, including:

    • Staying well-rested
    • Avoiding caffeine
    • Avoiding stimulants often found in over-the-counter medications, like cold remedies
    • Avoiding temperature extremes

    The following treatment options may be helpful: