Essential Tremor Services
Essential tremor is a neurological disorder that causes involuntary shaking in different parts of the body — hands, arms, head, chin, tongue and larynx (voice box). In rare cases, it may also affect the legs.
Essential tremor (ET) is the most common movement disorder, affecting an estimated 7 million Americans. It differs from tremors associated with other conditions, such as Parkinson’s disease or head trauma.
While it is not life-threatening, ET can be very distressing for patients. Because the shaking occurs with purposeful movements, simple actions like eating, writing or holding a cup can be challenging. As the disorder progresses and shaking becomes more pronounced, many patients find themselves anxious and embarrassed in social situations, which in turn may make the tremors worse.
UCI Health movement disorders specialists can help. Our team of fellowship-trained neurologists have extensive experience in diagnosing and treating essential tremor and all types of movement disorders.
For more information or to schedule a consultation, please call us at 714-456-7720.
Symptoms
Essential tremor can occur at any age, but it emerges more often in older adults. Symptoms may include:
- Tremors in different parts of the body, most notably when a person is moving
- A quivering voice
- Shaking that intensifies with emotional stress
- Tremors that worsen with age
Diagnosis
At UCI Health, our movement disorder experts provide patients with a thorough clinical evaluation. This includes a complete medical history of the individual and their family members, as well as an assessment of any medications a patient may be taking to help determine what factors may worsen or alleviate tremors.
We also look for any evidence of other features that could indicate a movement disorder other than ET.
Brain scans such as magnetic resonance imaging (MRI) and computed tomography (CT) are not helpful in diagnosing ET, but they may be performed to rule out other possible tremor causes.
Treatments
There is no cure for ET, but a variety of therapies are available that may relieve symptoms and improve quality of life.
Our UCI Health movement disorder specialists work with each patient to develop a personalized plan for reducing the tremors’ frequency. Treatment plans also take into consideration other medical conditions the patient may have, as well as specific features of individual medications.
Treatment options for ET include a broad range of drug therapies and surgical procedures.
Medications
Numerous medications have been shown to help patients control tremors and improve their ability to drink from a cup, write, use utensils or apply makeup.
Drugs most often used to treat ET include beta blockers such as propranolol or sotalol. Another commonly used medication is a seizure drug called primidone. About 50% to 60% of patients gain some improvement in functional abilities with these medications.
Other drugs that may help reduce ET include gabapentin, topiramate and zonisamide. When patients don't respond to these medications, anti-anxiety drugs such as alprazolam and clonazepam may be prescribed.
Another option for some patients are injections of botulinum toxin to reduce shaking.
Surgical procedures
Surgery may be considered for patients with disabling tremors when:
- Drug therapies cannot adequately control the shaking
- A patient can’t tolerate the medications
- Other medical conditions preclude giving medications
Surgical treatments generally focus on a part of the brain called the thalamus. They include:
- Image-guided focused ultrasound thalamotomy, which uses soundwaves to destroy a small portion of the thalamus
- Deep brain stimulation (DBS), which involves implanting a pacemaker-like device to regulate electrical activity in the thalamus
- Stereotactic thalamotomy, which uses radiation to destroy a small part of the thalamus
Above all, the goal of the UCI Health movement disorders team is to ensure that each patient receives the best possible care and achieves the highest quality of life with the fewest side effects.
