Essential tremor refers to a condition of involuntary shaking that occurs with activity. While it's most commonly found in the hands, essential tremor can affect any part of the body, including the head and the voice. The shaking movements of essential tremor are similar to those experienced by people with Parkinson's, but in reality, essential tremor is not caused by any other disease. Occasionally, several members of the same family will have this disorder, which is then called familial tremor. For many people, the symptoms of essential tremor are easily remedied through lifestyle adaptations, but some people may need more extensive treatment to resolve the problems associated with this disorder.
Drugs
According to the National Library of Medicine's Medline Plus encyclopedia (Reference 4), some people may get symptomatic relief from essential tremors by taking medicines such as propanolol and primidone, which block neurotransmitters, natural substances that transfer information between nerves and muscles.
These are powerful drugs, so they should be used cautiously. Potential side effects include fatigue, shortness of breath, nausea, and balance and coordination problems.
Anti-seizure drugs, mild tranquilizers and certain blood pressure medications may also be prescribed to help control tremors, according to Medline Plus. Some people have also found that botox injections in tremulous hands help by weakening the most affected muscles.
The International Foundation for Essential Tremor (Reference 1) adds the anticonvulsants gabapentin, which is sold under the brand name Neurontin®, and topiramate, or Topamax® as "emerging treatments," and lists a number of other drugs to control essential tremor that were under investigation as of spring 2010.
Surgery
The International Essential Tremor Foundation website reports that "only about 50 percent of patients receive satisfactory benefit from the currently available medications," and lists two surgical procedures that have shown promise in treating essential tremor: thalamotomy and thalamic deep brain stimulation.
A thalamotomy targets specific cells in the thalamus, a part of the brain responsible for relaying motor and sensory information. By destroying these cells, essential tremor can be effectively controlled. This surgery is effective if tremors are confined to one hand; treating both sides of the body is not recommended.
In deep brain stimulation, instead of destroying the thalamus cells, an electrode is placed at the site. A lead from the electrode is then attached, under the skin, to a device placed in the chest. The device emits mild electrical currents that control the tremor. This surgery has fewer complications than thalamotomy, but is more costly and requires more follow-up to adjust the electrical stimulation device.
Lifestyle
The Mayo Clinic's online guide to essential tremors lists a number of lifestyle adaptations that can help control tremors, starting with avoiding caffeine and other stimulants, which can worsen tremors. While many people report an initial calming effect on tremors after drinking alcohol, they also note that once the alcohol starts to wear off, the tremors tend to become even stronger; this is called the "rebound effect."
Stress and fatigue both increase the severity of essential tremors, so rest and relaxation are a good way to control them. Many relaxation techniques are available; activity such as walking, swimming or biking also reduces stress, and at the same time, aids in getting a good night's sleep.
