If you notice your hands are shaky when pouring a cup of coffee, holding a bridge hand or combing your hair, you may leap to the conclusion you are in the early stages of Parkinson disease. But actually, essential tremor is the most common form of abnormal trembling -- primarily of the hands.
Essential tremor is a nerve disorder in which tremors occur without an identifiable cause. The tremor resembles an exaggerated shaking and occurs when a person is using his or her hands but does not occur while the hands are at rest. Parkinson’s tremors are just the opposite – noticeable shaking when at rest but no shaking when the hands are engaged.
Some degree of tremor during movements is normal for everyone. Stress, fatigue, anger, fear, caffeine and cigarette smoking may temporarily worsen normal tremor to the point that it becomes visible to the naked eye.
Chronic essential tremor can occur at any age but is most common in people older than 65. It is a relatively benign condition, affecting movement or voice quality, but with no other effects. It involves a rhythmic, moderately rapid tremor of voluntary muscles.
Over time, essential tremor may involve hands, arms, head, voice box, eyelids, or other muscles. An essential tremor rarely affects the legs or feet. It may start in one body part but can progress to include other parts.
Any change in your normal body functioning should be discussed with your family physician. He or she can rule out the effects of excessive caffeine or tobacco use, alcohol withdrawal, or the use of certain medications (some asthma drugs, some antidepressants, lithium or some anti-seizure drugs). Other causes for tremors include hyperthyroidism, pheochromocytoma, Wilson's disease (a rare condition in which copper accumulates in the brain and liver) and other disorders.
An evaluation by a neurologist familiar with movement disorders will help distinguish essential tremor from Parkinson disease. Treatment for essential tremor may not be necessary unless tremors interfere with your ability to perform daily activities or if they are considered so embarrassing that you withdraw from normal activities.
For more information or to make an appointment with a Washington University Neurology movement disorder specialist, please call (314) 362-6908.