What Is Essential Tremor?

Essential tremor is a neurological disorder that leads to rhythmic shaking in the hands, legs, voice, trunk or head. Though it is often confused with Parkinson's disease, essential tremor is not tied to any other condition. It is the most common of all neurologic diseases, except stroke. It's even more common than Parkinson's disease.

Incidence of essential tremor

  • 50 percent of all patients have a family history of tremor.
  • 1 in 20 people older than age 40 may have essential tremor.
  • 1 in 5 people over 65 may have essential tremor.
  • There may be as many as 10 million people with essential tremor in the United States alone and many more worldwide.
  • The chance of developing essential tremor increases with advancing age.

Other Tremor Disorders

Enhanced Physiologic Tremor (EPT)

EPT has the same frequency characteristics as physiologic tremor but is easily visible and is mainly postural. The diagnosis not made if there is an underlying neurological pathology. Screening for potential metabolic derangements associated with tremor should be performed. The distinction between EPT and mild forms of ET is ambiguous and somewhat arbitrary, and is usually based on the presence and extent of functional disability with the latter.

Primary Orthostatic Tremor

Primary Orthostatic Tremor is a unique syndrome, characterized by the presence of high frequency (13-18Hz) tremor of the trunk and legs that occurs only with stance (Britton, 1995). In other words, patients are asymptomatic when lying or sitting. Symptoms rarely persist with walking. Yet, subjectively, patients report feeling unsteady when standing up. Constant change of position of the feet relieves the symptoms. Patients quickly learn to march in one spot. The clinical exam is benign but for minimally visible and sometimes only palpable fine amplitude rippling of the leg muscles. The diagnosis can be confirmed by the electromyography of the quadriceps muscles, which records a typical 13-18 Hz tremor pattern. Symptoms respond to low dose clonazepam.

Task and Position Specific Tremor

This is a group of tremor syndromes that shares the common feature of tremor activation when engaged in a specific task. The most common type is primary writing tremor, in which symptoms appear only or predominantly with that particular activity. Use of the limb with other activities (eating, weight-lifting, etc.) does not produce tremor. Other examples include task-specific tremors of musicians and athletes, as well as isolated voice tremor. In some of these cases, patients have dystonic posturing of the limb in conjunction with tremor, or focal dystonia with dystonic tremor.

Parkinson’s Disease and Movement Disorders Center 
Lavin Family Pavilion 
259 East Erie Street, Floor 19 
Chicago, Illinois 60611 
Main Number: 312.695.7950
Fax: 312.695.5747

Making an appointment
To make an appointment, or if you have any questions about our clinic, please contact our nurse coordinator at 312.695.7950.

Functional Neurosurgery Program at Northwestern Memorial Hospital

The Functional Neurosurgery Program specialists at Northwestern Memorial Hospital work in integrated teams to provide patients with a multidisciplinary approach to their care, including:

  • Assessment by a fellowship-trained neurologist in movement disorders and epilepsy
  • Comprehensive pharmacological therapy
  • Neurosurgical evaluations for deep brain stimulation (DBS), epilepsy surgery, pain surgery, intrathecal medication infusion and other therapeutic procedures
  • The opportunity to participate in clinical research trials
  • Physical, occupational and speech therapy through Northwestern Memorial Hospital in conjunction with the Rehabilitation Institute of Chicago
  • Social work services: consultation, counseling, support groups and access to community services and resources
  • Educational programs
  • Learning materials: books, videos, audiotapes and internet resources
  • Neuropsychology services

The board-certified neurologists at Northwestern Medicine Lake Forest Hospital are trained in the diagnosis and treatment of nervous system disorders, including diseases of the brain, spinal cord, nerves and muscles. They diagnose and treat patients with a full range of neurological disorders, including essential tremor.

Northwestern Medicine Central DuPage Hospital Movement Disorders and Neurodegenerative Disease Center

Your movement matters—at home, at work, even while doing the common tasks that everyone can take for granted. If you have a movement disorder, you deserve a level of care that can get you back to doing the things you love, with confidence and peace of mind.

The Northwestern Medicine Central DuPage Hospital Movement Disorders and Neurodegenerative Disease Center uses an interdisciplinary team approach to provide individualized care that optimizes your treatment, outcomes and experience. Your care is provided by a focused and experienced team that includes specially trained neurologists, neurosurgeons, neuropsychologists, nurses, counselors and rehabilitative specialists who offer advanced treatment options and access to support and resources.

For more information or to make an appointment, please contact us at 630.933.4056.

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