Essential Tremor

UT Southwestern Medical Center’s movement disorders specialists have expertise in diagnosing and treating essential tremor, the most common movement disorder. We take a multidisciplinary approach to treatment, helping to reduce symptoms and enhance patients' well-being.

UT Southwestern is one of the few academic medical centers in the country to offer MR-guided high-intensity focused ultrasound (MRgHIFU) as a minimally invasive treatment option for essential tremor.

Pioneers in Essential Tremor Treatment

Essential tremor is a disorder that affects the central nervous system. Often confused with Parkinson's disease, it’s characterized by uncontrolled, rhythmic shaking. Essential tremor is sometimes also referred to as benign essential tremor or familial tremor. Although it can affect nearly any part of the body, the tremor occurs most often in the hands.

Essential tremor is not life threatening, but it can make it hard for people to perform everyday tasks.

UT Southwestern has expertise in diagnosing essential tremor and providing comprehensive, individualized care to treat it. Our Movement Disorders Program is a major regional referral center for disorders such as essential tremor.

Additionally, UT Southwestern researchers are conducting pioneering research to treat essential tremor; their initiatives include efforts to improve patient outcomes through deep brain stimulation surgery and using advanced nonsurgical techniques to locate the precise area in the brain linked to essential tremor.

Causes of Essential Tremor

The exact causes of essential tremor are unknown, but it’s believed to be caused by electrical fluctuations in the brain. About half of all cases are caused by a genetic mutation, passed from parent to child.

Although it can occur at any age, essential tremor is most common in people older than 65.

Diagnosing Essential Tremor

To diagnose essential tremor, we begin with a thorough evaluation, which includes a:

• Physical exam
• Discussion of personal and family medical history
• Discussion of symptoms and risk factors

Additional tests we may recommend include:

• Neurological examination: A thorough evaluation of muscle strength, coordination, and other functions of the nervous system
• Laboratory tests: Tests of the blood and urine that look for signs of metabolic issues, thyroid disease, or other problems
• Performance tests: Activities to measure the tremor itself, such as writing or drawing a spiral

To rule out other causes of the symptoms, we might recommend stopping excessive alcohol consumption, avoiding caffeine, or avoiding or decreasing certain medications.

In certain situations, we might order an imaging test called a dopamine transporter scan (DaTscan) to help us determine if a patient has Parkinson's disease instead of essential tremor.

Essential Tremor Treatment

Some patients manage their tremor without treatment.

When a patient seeks treatment, we typically prescribe medications, such as:

• Beta blockers: These medications, typically used to treat high blood pressure, can reduce tremors in some people.
• Anti-seizure medications: Some epilepsy drugs are effective in people who don't respond to beta blockers.
• Tranquilizers: If a patient’s tremors are triggered by anxiety, we might recommend benzodiazepine drugs.
• Botox injections: Botox can be particularly effective at treating head and voice tremors.

If medications become less effective over time, or if a patient is bothered by their side effects, we might recommend additional treatments.

UT Southwestern is one of the few academic medical centers in the United States that offers MR-guided high-intensity focused ultrasound (MRgHIFU) to treat essential tremor. This minimally invasive technique uses an ultrasound beam to ablate, or burn away, problem tissue. Our advanced imaging techniques improve targeting precision.

Another treatment option is deep brain stimulation. This technique involves surgically implanting two electrodes in the brain and connecting them to a pacemaker. In most patients, this treatment successfully improves functionality.