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Genetics Home Reference: your guide to understanding genetic conditions
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Essential tremor

Reviewed June 2013

What is essential tremor?

Essential tremor is a movement disorder that causes involuntary, rhythmic shaking (tremor), especially in the hands. It is distinguished from tremor that results from other disorders or known causes, such as Parkinson disease or head trauma. Essential tremor usually occurs alone, without other neurological signs or symptoms. However, some experts think that essential tremor can include additional features, such as mild balance problems.

Essential tremor usually occurs with movements and can occur during many different types of activities, such as eating, drinking, or writing. Essential tremor can also occur when the muscles are opposing gravity, such as when the hands are extended. It is usually not evident at rest.

In addition to the hands and arms, muscles of the trunk, face, head, and neck may also exhibit tremor in this disorder; the legs and feet are less often involved. Head tremor may appear as a "yes-yes" or "no-no" movement while the affected individual is seated or standing. In some people with essential tremor, the tremor may affect the voice (vocal tremor).

Essential tremor does not shorten the lifespan. However, it may interfere with fine motor skills such as using eating utensils, writing, shaving, or applying makeup, and in some cases these and other activities of daily living can be greatly impaired. Symptoms of essential tremor may be aggravated by emotional stress, anxiety, fatigue, hunger, caffeine, cigarette smoking, or temperature extremes.

Essential tremor may appear at any age but is most common in the elderly. Some studies have suggested that people with essential tremor have a higher than average risk of developing neurological conditions including Parkinson disease or sensory problems such as hearing loss, especially in individuals whose tremor appears after age 65.

How common is essential tremor?

Essential tremor is a common disorder, affecting up to 10 million people in the United States. Estimates of its prevalence vary widely because several other disorders, as well as other factors such as certain medications, can result in similar tremors. In addition, mild cases are often not brought to medical attention, or may not be detected in clinical exams that do not include the particular circumstances in which an individual's tremor occurs. Severe cases are often misdiagnosed as Parkinson disease.

What genes are related to essential tremor?

The causes of essential tremor are unknown. Researchers are studying several areas (loci) on particular chromosomes that may be linked to essential tremor, but no specific genetic associations have been confirmed. Several genes as well as environmental factors likely help determine an individual's risk of developing this complex condition. The specific changes in the nervous system that account for the signs and symptoms of essential tremor are unknown.

How do people inherit essential tremor?

Essential tremor can be passed through generations in families, but the inheritance pattern varies. In most affected families, essential tremor appears to be inherited in an autosomal dominant pattern, which means one copy of an altered gene in each cell is sufficient to cause the disorder, although no genes that cause essential tremor have been identified. In other families, the inheritance pattern is unclear. Essential tremor may also appear in people with no history of the disorder in their family.

In some families, some individuals have essential tremor while others have other movement disorders, such as involuntary muscle tensing (dystonia). The potential genetic connection between essential tremor and other movement disorders is an active area of research.

Where can I find information about diagnosis or management of essential tremor?

These resources address the diagnosis or management of essential tremor and may include treatment providers.

  • Genetic Testing Registry: Hereditary essential tremor 1 (http://www.ncbi.nlm.nih.gov/gtr/conditions/C1860861)
  • Johns Hopkins Movement Disorders Center (http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/movement_disorders/conditions/essential_tremor.html)
  • MedlinePlus Encyclopedia: Essential Tremor (http://www.nlm.nih.gov/medlineplus/ency/article/000762.htm)

You might also find information on the diagnosis or management of essential tremor in Educational resources (http://www.ghr.nlm.nih.gov/condition/essential-tremor/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/essential-tremor/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about essential tremor?

You may find the following resources about essential tremor helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for essential tremor?

  • benign essential tremor
  • familial tremor
  • hereditary essential tremor

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about essential tremor?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding essential tremor?

anxiety ; autosomal ; autosomal dominant ; benign ; cell ; dystonia ; familial ; gene ; hereditary ; inheritance ; inheritance pattern ; inherited ; involuntary ; motor ; nervous system ; neurological ; prevalence ; stress ; trauma ; tremor

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

  • Blair MA, Ma S, Phibbs F, Fang JY, Cooper MK, Davis TL, Hedera P. Reappraisal of the role of the DRD3 gene in essential tremor. Parkinsonism Relat Disord. 2008 Aug;14(6):471-5. doi: 10.1016/j.parkreldis.2007.11.002. Epub 2008 Mar 3. (http://www.ncbi.nlm.nih.gov/pubmed/18316228?dopt=Abstract)
  • Deng H, Le W, Jankovic J. Genetics of essential tremor. Brain. 2007 Jun;130(Pt 6):1456-64. Epub 2007 Mar 12. Review. (http://www.ncbi.nlm.nih.gov/pubmed/17353225?dopt=Abstract)
  • Hawley JS, Robottom BJ, Weiner WJ. Essential tremor. Rev Neurol Dis. 2010 Spring-Summer;7(2-3):e69-75. Review. (http://www.ncbi.nlm.nih.gov/pubmed/20944525?dopt=Abstract)
  • Jasinska-Myga B, Wider C. Genetics of essential tremor. Parkinsonism Relat Disord. 2012 Jan;18 Suppl 1:S138-9. doi: 10.1016/S1353-8020(11)70043-8. Review. (http://www.ncbi.nlm.nih.gov/pubmed/22166413?dopt=Abstract)
  • Lorenz D, Deuschl G. Update on pathogenesis and treatment of essential tremor. Curr Opin Neurol. 2007 Aug;20(4):447-52. Review. (http://www.ncbi.nlm.nih.gov/pubmed/17620881?dopt=Abstract)
  • Louis ED. Essential tremor. Handb Clin Neurol. 2011;100:433-48. doi: 10.1016/B978-0-444-52014-2.00033-1. Review. (http://www.ncbi.nlm.nih.gov/pubmed/21496600?dopt=Abstract)
  • Shill HA, Adler CH, Beach TG. Pathology in essential tremor. Parkinsonism Relat Disord. 2012 Jan;18 Suppl 1:S135-7. doi: 10.1016/S1353-8020(11)70042-6. Review. (http://www.ncbi.nlm.nih.gov/pubmed/22166412?dopt=Abstract)
  • Testa CM. Key issues in essential tremor genetics research: Where are we now and how can we move forward? Tremor Other Hyperkinet Mov (N Y). 2013;3. pii: tre-03-105-1843-1. Epub 2013 Jan 22. (http://www.ncbi.nlm.nih.gov/pubmed/23450143?dopt=Abstract)
  • Zeuner KE, Deuschl G. An update on tremors. Curr Opin Neurol. 2012 Aug;25(4):475-82. doi: 10.1097/WCO.0b013e3283550c7e. Review. (http://www.ncbi.nlm.nih.gov/pubmed/22772877?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: June 2013
Published: December 16, 2014