What is essential tremor?
Essential Tremor (ET) is a common neurological disorder characterised by involuntary shaking or trembling of parts of the body, typically the hands, arms, head, or voice. Unlike Parkinson’s tremors, ET occurs during voluntary movements and can worsen with stress or fatigue. It tends to run in families and often begins gradually, worsening over time. While not life-threatening, it can significantly affect daily activities such as writing, eating, or performing precise tasks. Treatment options include medications, lifestyle modifications, and, in some cases, surgical interventions to manage symptoms and improve the quality of life for those affected.
Essential tremor typically manifests as a postural or action tremor, meaning it occurs when the affected limb or body part is held against gravity or during intentional movement, such as writing or drinking. The tremor can vary in severity, from mild shaking that is barely noticeable to more pronounced tremors that can significantly interfere with daily activities and quality of life. The exact cause of essential tremor is not fully understood, but it is believed to involve abnormal electrical brain activity affecting the pathways that control movements.
It’s important to note that both ET (Essential Tremor) and Parkinson’s are movement disorders and sometimes they can be mistaken for each other. However, there are many differences between the two conditions, and proper and early diagnosis is important for receiving the right treatment and support.
Prevalence:
ET is approximately twice as common as Parkinson’s.
Age of onset:
Parkinson’s is most commonly diagnosed in people over the age of 60. ET can occur at any age, even in childhood, but is most commonly diagnosed in the 40s.
Tremor characteristics:
In Parkinson’s, the tremor is mostly seen at rest and may be referred to as “resting tremor”. In ET, the tremor occurs mostly during action or movement, though this occurs in Parkinson’s as well.
Body parts affected:
The tremor in Parkinson’s usually starts on one side of the body and may develop on the other side as the disease progresses. In ET, the tremor usually affects both sides from the start of the condition.
Other symptoms:
In ET, tremor is the primary symptom. In Parkinson’s, there are four primary symptoms that affect movement, including tremor, stiffness/rigidity, bradykinesia (slowed movements), and balance issues. Parkinson’s is also accompanied by many non-motor symptoms.
Genetics and family fistory:
In cases of Parkinson’s, there is rarely a family history (estimated genetic link in only 10-20% of cases), but in ET, a family history of tremor is seen in more than 50% of cases.
How do I access assistive technology (AT) for my tremor?
Accessing occupational therapy services can provide you with a good start as to what AT is available. You can also go look at assistive technology retailers or disability equipment suppliers. These stores specialise in providing a wide range of products designed to assist you in your daily activities, mobility, communication, and overall quality of life.
It’s advisable to explore all available pathways to find the support that best suits your individual needs. Look to:
- getting a GP referral to an OT with Parkinson‘s experience
- your state-based Parkinson’s organisation for advice on OTs and stores to access
- private health to see what is covered in relation to OT consultations and AT expenses
- NDIS or My Aged Care plan supports for OT and AT costs.
Infosheet kindly reviewed by Essential Tremor Australia
Essential Tremor (ET) affects more than 300,000 Australians, and yet, it’s often misunderstood or overlooked. At Essential Tremor Australia, we’re here to change that. We champion awareness, connection, and support for people of all ages living with ET, from the first signs of tremor to navigating daily life with dignity and confidence. We advocate for better recognition, improved care pathways, and access to the tools that help people thrive. www.essentialtremor.org.au
References:
Essential Tremor Australia www.essentialtremor.org.au
International Essential Tremor Foundation https://essentialtremor.org/
Tremor: A systematic approach https://www1.racgp.org.au/ajgp/2024/supplement-december/tremor
Deuschl G, Raethjen J, Hellriegel H, Elble R. Treatment of patients with essential tremor. Lancet Neurol 2011;10(2):148–61. doi: 10.1016/s1474-4422(10)70322-7.
Louis ED. Essential tremor: A nuanced approach to the clinical features. Pract Neurol 2019;19:389–98. doi: 10.1136/practneurol-2018-002183.
Rajput AH, Rajput A. Medical treatment of essential tremor. J Cent Nerv Syst Dis 2014;6:29–39. doi: 10.4137/JCNSD.S13570.
Vetterick C, Lyons KE, Matthews LG, Pendal R, Ravina B. The hidden burden of disease and treatment experiences of patients with essential tremor: A retrospective claims data analysis. Adv Ther 2022;39(12):5546–67. doi: 10.1007/s12325-022-02318-8.
Zesiewicz TA, Elble RJ, Louis ED, et al. Evidence-based guideline update: Treatment of essential tremor: Report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology 2011;77(19):1752–55. doi: 10.1212/WNL.0b013e318236f0fd.
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