What is Essential Tremor (ET)?
ET is a nervous system disorder that causes involuntary, rhythmic shaking. Although it can affect any part of the body, it most commonly occurs in one or both hands. Unlike Parkinson’s disease, which has many symptoms besides tremors, ET is considered an isolated tremor disorder, meaning the tremor is the main and often only feature of this condition. Familial essential tremor is caused by an alteration in the DNA; people without this genetic component can also develop ET.
While not life-threatening, the disease can greatly impact your quality of life and ability to perform activities of daily living. People with ET often find that everyday tasks such as eating, shaving, and writing are affected.
ET becomes more common after age 40. It affects about 4 to 5% of people aged 65 and above, and the tremor may worsen with age.
Beyond the difficulty of completing tasks that require fine motor movements, if the shaking is severe, people with ET might have to stop driving or working. Some give up eating in restaurants, going to social functions, shopping, or pursuing hobbies. The resulting isolation can create interpersonal problems.
Treatment for ET
When ET reaches the point where simple activities become daily struggles, the neurologists at UHealth’s Division of Movement Disorders can help. Though there is no cure for ET or any treatment that stops the disease from progressing, treatment can greatly improve your symptoms and enhance your quality of life.
As South Florida’s only university-based health system, we offer expert diagnosis and skilled, compassionate care from neurologists who specialize in movement disorders such as ET.
Our treatment options include:
• Focused Ultrasound
Focused Ultrasound (FUS), also known as MRI-guided Focused Ultrasound, is a non-surgical, noninvasive treatment that uses focused sound waves to destroy targeted tissue without affecting surrounding areas of the brain. For many patients, this safe, incision-free alternative to traditional surgery provides immediate relief from essential tremor symptoms. FUS delivers high-frequency ultrasound energy to a precise location in the brain (ventral intermediate nucleus of the thalamus), an area responsible for tremor. The energy converges to create heat, forming a small ablation that disrupts tremor pathways.
• Lifestyle modifications
Our movement disorder specialists evaluate your condition and lifestyle, then recommend ways to alleviate factors that affect tremor, including stress, fatigue, pain, and other stressors.
• Physical and occupational therapy
Physical therapy (PT) won’t stop the shaking, but will strengthen the muscles affected by ET, which improves dexterity and coordination.
Our occupational therapists can instruct you how to compensate for symptoms using tools specifically designed for people with movement disorders.
Newer wearable devices that resemble a sports watch provide short-term symptom relief by stimulating nerves in the forearm. Many individuals wear the devices before attending social events or performing tasks requiring fine motor skills.
• Medication
Beta-blockers such as propranolol (Inderal) and antiepileptic/anticonvulsants such as primidone (Mysoline) are commonly prescribed to treat ET. On average, both drugs reduce tremor by about 50%. Newer drugs are currently being evaluated in clinical trials. Our neurologists stay abreast of the latest research and treatments.
• Surgery
When medication isn’t effective or tolerated, deep brain stimulation (DBS) can bring welcome relief for patients whose tremor significantly impacts their life. In a two-step procedure, our neurosurgeons implant a device that works like a pacemaker for the brain. The procedure has been highly successful in reducing the physical symptoms of Parkinson’s disease and also helps patients with movement disorders like ET. DBS reduces tremor by about 90%, which allows many patients to reduce their ET medication. UHealth’s Division of Movement Disorders is a leader in DBS treatment in South Florida, and our physician-researchers conduct clinical trials on devices from the three major DBS manufacturers.
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