National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Essential tremor

Not a rare disease Not a rare disease
Other Names:
Benign essential tremor; Presenile tremor syndrome; Familial essential tremor; Benign essential tremor; Presenile tremor syndrome; Familial essential tremor; Tremor, hereditary essential, 1; Hereditary essential tremor See More
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Essential tremor is the most common movement disorder.  It is characterized by involuntary and rhythmic shaking (tremor), especially in the hands, without any other signs or symptoms. It is distinguished from tremor that results from other disorders or known causes, such as tremors seen with Parkinson disease or head trauma.[1][2] Most cases of essential tremor are hereditary. There are five forms of essential tremor that are based on different genetic causes. Several genes as well as lifestyle and environmental factors likely play a role in a person's risk of developing this complex condition.[1] In mild cases, treatment may not be necessary. In cases where symptoms interfere with daily living, medications may help to relieve symptoms.[3] 

 

 

Last updated: 9/12/2014
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, are likely involved in an individual's risk of developing this complex condition.[1] 
Last updated: 9/12/2014
About half of all cases of essential tremor appear to occur because of a genetic mutation. This is referred to as familial tremor.[4] In these cases, essential tremor appears to be passed through generations in families, but the inheritance pattern varies. In many affected families, the condition appears to be inherited in an autosomal dominant manner, which means one copy of an altered gene in each cell is sufficient to cause the disorder. In other families, the inheritance pattern is unclear. Essential tremor may also appear in people with no history of the disorder in their family.[1]

In some families, there are individuals who 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.[1]  

Last updated: 9/12/2014
Treatment for essential tremor may not be necessary unless the tremors interfere with daily activities or cause embarrassment.[3] Although there is no definitive cure for essential tremor, medicines may help relieve symptoms.[2][3] How well medicines work depend on the individual patient.[3] Two medications used to treat tremors include:[2][3]
  • Propranolol, a drug that blocks the action of stimulating substances called neurotransmitters, particularly those related to adrenaline
  • Primidone, an antiseizure drug that also control the function of some neurotransmitters

These drugs can have significant side effects.[3]

Eliminating tremor "triggers" such as caffeine and other stimulants from the diet is often recommended. Physical therapy may help to reduce tremor and improve coordination and muscle control for some patients.[2]
 
More details about the management of essential tremor can be accessed through the Mayo Clinic and Medscape.

Last updated: 9/12/2014

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Essential tremor. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • MayoClinic.com provides information about essential tremor. Click on the link to view this information.
  • Genetics Home Reference (GHR) contains information on Essential tremor. This website is maintained by the National Library of Medicine.
  • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
  • The National Institute of Neurological Disorders and Stroke (NINDS) collects and disseminates research information related to neurological disorders. Click on the link to view information on this topic.
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • Online Mendelian Inheritance in Man (OMIM) lists the subtypes and associated genes for Essential tremor in a table called Phenotypic Series. Each entry in OMIM includes a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Essential tremor. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • How often does essential tremor progress to a severe case? Is it common for essential tremor to involve the head and legs? What rare diseases have similar symptoms as essential tremor? See answer

  • I am curious if this condition can or will effect hearing. Not necessarily hearing loss, but muffled sounds, feeling pressure, etc. See answer

  • I have a relative who has essential tremor. How might this condition affect the activities of daily living? Are there ways to manage the symptoms? See answer


  1. Essential tremor. Genetics Home Reference (GHR). June 2013; http://ghr.nlm.nih.gov/condition/essential-tremor.
  2. NINDS Essential Tremor Information Page. National Institute of Neurological Disorders and Stroke (NINDS). April 25, 2013; https://www.ninds.nih.gov/Disorders/All-Disorders/Essential-Tremor-Information-Page.
  3. Essential tremor. MedlinePlus. 2014; http://www.nlm.nih.gov/medlineplus/ency/article/000762.htm.
  4. Essential tremor. MayoClinic.com. 2013; http://www.mayoclinic.com/print/essential-tremor/DS00367/METHOD=print&DSECTION=all.