Part I Diagnosis & Treatment Options for Essential Tremor

In this informative Zoom presentation, Dr. Avram Fraint, neurologist with Northwestern Medicine, Chicago, discusses the pathogenesis of essential tremor, genetic factors, diagnostic techniques and non-surgical treatment.

[@vickimckenna66]

I have had ET since I was in my early 20’s. Mine has gotten so bad sometimes that I can’t get a spoon to my mouth. I have tried a beta blocker which didn’t seem to help and cannabis oil for 6 months that made the tremors worse. I live in Ontario Canada where it is legal. I have tried different exercises without much luck either. Lately I have been using knitting to help with the tremors. When they are particularly bad I try the knitting. When I start I have a very hard time with the pearl stitch and it takes a lot of concentration. If I persist after about 1 hour my hand tremors subside and I am able to write with a pen. After doing this for a week, I seem to continue having this as a prolonged effect. I am not sure why this works for me. I feel it may have something to do with forcing my brain to concentrate on a task. I am hoping this might help someone else until they find a more lasting solution. I have only been trying this for about 6 months. Maybe the only good result will be that my daughter will have at least 2 nice sweaters for next winter.😊

[@keithbriggs971]

Finally a name for what I have experienced since birth. My arms and hands shake and balance has always been bad. I have had many doctors either say your ok, to they don't know and one diagnosed Parkinsons. My tremors can go from almost none to unable to write or hold a glass of water, depending on the day.

[@jeanniejamieson3014]

I am the youngest of 4 children (now 62). Our mother had ET, and each of my siblings including myself have it. Mine started showing in my hands when I was in my 30s. I have 2 nephews who also have signs of it now - they are in their early 50s. Thank you for your informational videos! My oldest brother and myself currently take propranolol for it.

[@angeluser4699]

Dose it work

[@chetanrs]

Is the medication effective ?

[@carikshawn4201]

I've had a slight head tremor for many years but nothing that has been difficult. For a few years though, I suddenly developed a vestibular disorder which causes a balance and dizzy problem as well as my right thumb moves....over the past 3 mos, I'm noticing my voice is changing at times. Turns out my brother also has his right hand moving so it has to be a family thing. I am going for physical therapy for the vestibular problem and listening to this discussion, they are talking about the cerebellum which is also involved in my vestibular problem.

[@alexandrawhitelock6195]

There is some 'research' about using v.high doses of B1 mostly via injection

[@annphillips4300]

Botox for my head tremor has been amazing - I also get botox for my voice tremors which helps.

[@susanjohnston4066]

Could you please provide more details regarding dose and frequency and place of injection? Thanks so much.

[@annphillips4300]

@@susanjohnston4066 The botox injections are in my neck every 3 months--also for vocal cords in my neck--pain is minimum and I have had great results for several years with this treatment. I guess my physician would have to answer questions regarding dosage, etc.

[@cmatkovich7559]

my tremors are in my legs. I started with semite and that did very well, until i started falling, I fell down 11 times in one day the doctor said I have another problem and said I have Parkisons I on medication for that too. I am still falling down,, I use a walker but it still scares me when I fall and it hurts a lot too

[@nurofenaddict5905]

any one tell me what treament there on

[@anishsharma2485]

I think I have stationary tremors. They occur at random place. I don't have any tremors while moving or resting it occurs when I fully open my hands and pick something then they little shake but when I move my hands they doesn't shake. Should I we worried of them to increase. This happen 1 and half month ago.

[@hermanparisius784]

thank you!, very helpful and concise info. I am looking for a doctor whom is able to explain in detail the origin and workings of ET, using medical terms rather than somewhere in cerebellum or in brain. Is that possible or is there not enough research /knowledge to explain this? I know of one young patient whom takes GABA (supplement) with Magnesium reducing the tremors 80%. What are some of the external factors increasing onset of ET or no ET? (The twin story in this lecture).

[@EssentialTremorIETF]

We have a Find a Physician database on our website that might be helpful to you. Perhaps you could find a movement disorder specialist nearby with whom you can have a discussion. www.essentialtremor.org. Research as to the cause of ET is ongoing and you are right, there is not enough. We have expanded our research grant program thanks to a generous donation last year and we are hopeful that this will jumpstart the process. We often hear people talk about adding a supplement of some kind to their diet which helps with the tremors, and in these instances, clearly the patient had a deficiency of some kind that was causing the tremors, which is not the same thing as essential tremor.

[@cryptoworld8554]

i have essential tremour and it sucks

[@kimballentyne3482]

Thank you for sharing your information about essential tremors. What wrist bracelets actually work? Does extra vitamin B12 help to reduce essential hand tremors? What about Focus Ultrasound? Can you recommend specific daily exercises to reduce essential tremors in the hands?

[@EssentialTremorIETF]

There are a number of assistive devices and therapies on the market. Since everyone's ET is individual to them, what works for one person doesn't always work for another. We encourage you to try them out if you can (most provide a money back guarantee). We have a list of devices and therapies on our website at essentialtremor.org/resource/assistive-devices/. We also have information about focused ultrasound as well as deep brain stimulation (with links to more information). Here is that link: essentialtremor.org/resources/living-with-et/treatments/. An occupational or physical therapist would be able to provide you with some exercises or therapies to try for tremor reduction. Many times people practice meditation and deep breathing to calm them temporarily.

[@bobwilson214]

Has anyone seen cases where a wind instrument musician has had trouble controlling his/her breath while playing, due to a diagnosed tremor? I am having that trouble now, and I believe it is due to my diagnosed ET, but my neurologist hasn't really heard of cases like that.

[@smoosmoo22]

I have a diaphragmatic tremor that I notice periodically. It can happen when I am trying to deep breathe before sleep

[@kimwright8795]

Well i have et in my hands sometime s it takes my legs and mouthwhen i am stress

[@ShivaalTiluk]

Thank you for your work - I have a question, no known family members of mine have ET.. Could mine be a biological anomaly? Also, i had a bad fall, landing on the back of my head as a child.. What kind of scans would show any defects in my brain?

[@EssentialTremorIETF]

Not all essential tremor is inherited from a parent. There are many people who have it with no family history. MRIs and CT scans are most often the tests used to look at the brain to check for bleeding, swelling, abnormalities in general.

[@gonegirl7777]

@@EssentialTremorIETF I just started shaking and buzzing inside my body a little over a year ago. Its horrible. It never stops and its powerful buzzing pulsing feeling. It moves sometimes, I just want it to stop.😭

[@salman-11924]

My tremors have improved but are not gone after B12 and Citicoline supplementation (I had a confirmed b12 deficiency), does that rule out ET? I found a study with a small sample that suggested Citicoline for ET but I don’t know if it’s conclusive. I either have early ET or physiologic tremors exacerbated by stress and vitB deficiency and it’s hard to tell. My neurologist did not encourage me to directly treat it as “if I take medications for it, I would have to take them for life”.

[@EssentialTremorIETF]

It is difficult for us to answer this question as we are a support foundation, and don't have a physician on staff. It's best to talk with your physician. In the past, what we have seen is some people are B12 deficient and it causes a tremor. If that is truly the case with you, then it's probable that you had a B12 deficiency and not ET. But again, please check with your doctor.

[@universezero2590]

How do I get my new doctor to refer me to Neurology he thinks the cause of my jitteriness as he says is from Low iron but are more like tremors to me .He will not do any other tests besides the basic should I get a second opinion

[@EssentialTremorIETF]

It sure doesn't hurt to get a second opinion, but it's up to you of course. Did you tremors calm down once your iron level was stabilized?

[@marshmellowdalamacorn3339]

Sir, my father as well as my grandfather has essential tremors, and Im worried that I might have one. Im 14 so it’s hard to tell but Im afraid I might have it... is there a sure way to tell?

[@EssentialTremorIETF]

Have you seen a movement disorder specialist (neurologist who specializes in movement disorders)? It's important to get a diagnosis if you are having symptoms. That is a place to start.

[@julesmurphy7046]

My daughter has tremors and taking medication but it’s not showing improvement. Where can she get a custom made glove in GA. Please advise.

[@EssentialTremorIETF]

There are several glove type devices on the market. We have some listed on our website under "orthotics." Here is the link: essentialtremor.org/resource/assistive-devices/

[@michelehunt4837]

UC San Diego did trials using CBD...have the results been released?

[@EssentialTremorIETF]

The study has stalled because of the COVID-19 pandemic. Many research studies around the country have been put on hold because they are finding it hard to hold in-person trials, and also the focus for many companies is now on COVID-19 studies.

[@anthonyreed480]

I'm interested in this too. If self-medicating with alcohol isn't recommended surely something like this makes sense (if it works).

[@shraddhasoni8173]

Hello sir...i have hand tremour from past 4 to 5 year...left hand is more prone than right hand ..taking propenolol...past 2 year ..what can i do bcs i am medicos and this problem decrese my confidance ..and i feel very tens about it plz help me

[@EssentialTremorIETF]

Please know you are not alone. More than 10 million people in the U.S. alone struggle with essential tremor. It sounds like you need support and to connect with others who have ET. We have a private support group online through Facebook called the Essential Tremor Awareness Group. Please consider connecting with this group. You will be asked a couple of questions that will allow you to access it, then just introduce yourself to the group and let them know you are new. Ask them questions about how they manage their ET. There is a search feature that allows you to look for past conversations on a variety of topics. Here is the link: facebook.com/groups/5884699022/

[@atulsingh1419]

I am also a medico student.I m 24 years old, during writing i faced problem.I got more nervous when i write in front of teachers and my friends My father and grandfather also suffering

[@vincentchung8184]

Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@vincentchung8184]

@@atulsingh1419 Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@yasminemn2311]

Hi, my doctor in the physical exam asked me only to fold a paper. Is that really enough to say that I have ET? (In addition he asked if some family members have this and I said no. He asked if I have rest tremor , I said yes when I don't move I feel movement but internal one. And he checked my thyroid gland hormones and they were fine)

[@hermanparisius784]

This sounds like an "internal tremor". A lot of patients find that almost more difficult to bear than the actual tremors. Unfortunately there are no doctors interested in this or even ask about this in their exam.

[@yasminemn2311]

@@hermanparisius784 Ok thank you :) That is unfortunate indeed, because when they don't talk about this or about all sides of ET it can be confusing. I was feeling in the beginning what if I was diagnosed wrongly. I confirm, for me too internal tremors are worse.

[@kath3611]

no

[@yasminemn2311]

@@kath3611 Thanks

[@PRAVEENBAID]

If my mri & EEG all scans are normal can focus ultrasound treatment works in such conditions kindly reply ... Please

[@EssentialTremorIETF]

This is a question for your doctor.

[@PRAVEENBAID]

@@EssentialTremorIETF ok sir thanks

[@kareemahmed7028]

Hello Doctor, I used Propranolol and it was a very good treatment, but I suffer from bronchiectasis and phlegm from the lungs, which negatively affected my lungs..Is there an alternative treatment for Propranolol?

[@EssentialTremorIETF]

This is the International Essential Tremor Foundation replying to your comment. We have a list of commonly used medication for essential tremor that may be helpful to you. Here is the link: essentialtremor.org/wp-content/uploads/2020/08/MedicationSheet-January-2019.pdf

[@kareemahmed7028]

thank you dr.@@EssentialTremorIETF

[@garyandleslied]

I'm on a antidepressant venlafaxine. Could that give people tremors similar to essential tremor. I have been on antidepressants for years and have a tremor. The Dr says it isn't but I still wonder. I don't want to discourage anyone to take their antidepressants cause medicines can effect everyone differently and many need these.

[@chanantornsuksawatt3665]

Yes it can be

[@mariopenulli1395]

Interesting, I took Venlafaxine for a few years, stopped and 3 years later i'm here with essential tremor.

[@Mlrjk]

Ive had a fremfor for several years now, and a few months ago it started to tickle in my hands and legs. What could it be, and what can I do to make the feeling go away?

[@EssentialTremorIETF]

Have you seen a neurologist and been formally diagnosed with essential tremor?

[@brucehinds5414]

is the braclit available

[@EssentialTremorIETF]

I believe you are referring to the Cala Trio. Here is the website where you can learn more: www.calatril.com.

[@carikshawn4201]

It is available but it costs well over $3,000 and if you are on Medicare, they don't pay for it. However. I asked my neurologist and she said while it's pricey it doesn't work all that well YET...she's hoping they will develope something that works better...

[@joker-vj4dk]

sir, I am from India. I have tremor. is there any treatment in India?please reply

[@EssentialTremorIETF]

We just did a Google search and found there is a neurosurgery center in Mumbai. You can do some Google searches to see what's near you. neurologicalsurgery.in/disease/tremors/treatment/

[@ashlinchris9192]

I am from India and i too have ET :(

[@angeluser4699]

@@ashlinchris9192 try Cbd oil

[@ashlinchris9192]

@@angeluser4699 ohhh is it showing any sort of improvements

[@dhandekrushna4055]

I am also from India and I have essential tremor since I was 18 and i am 24 now

[@user-xz7xt4kq6p]

Purl yRnn forward knit next stitch

[@bobwilson214]

I am 72, and have had a head tremor for 5_6 years, progressing to finger tremors (right side only.) My neurologist diagnosed me with ET by watching me at rest, vs. using my hands and talking with animation. My father had Parkinson's before he died, and I'm wondering whether it should have more extensive testing done?

[@EssentialTremorIETF]

If you are looking to verify that you have ET and not Parkinson's, the best test is a DaTscan. This is a neuroimaging tool (brain scan) that can assist in differentiating ET and PD. It involves a picture of the brain to measure dopamine levels. In PD, an abnormal scan representing a reduction in dopamine levels is seen. If no reduction in dopamine levels is seen, PD can be ruled out.

[@sanjubanick6649]

sir my tremor started from my hand when i was kid then as the days gose on its spread to head and legs and it’s increasing day bay day naw im 26 , it’s makin me less confident while donig any thing , it’s killing my self confidence please sir help me, im beging to you please

[@EssentialTremorIETF]

Are you under the care of a neurologist? It's important that you receive a proper diagnosis.

[@sanjubanick6649]

no sir , i don’t have balance , i’m from a very poor family.😔😔

[@sanjubanick6649]

i was doing a job as waiter in a restaurant but because of my shivering problem none of any restaurants woners give me good salary so i couldn’t meet a good doctor, after few months of donig job in a restaurant the woner don’t want me in his restaurant then i search another job , but sir believe me i try to give my full effort but my body do not give support.

[@vincentchung8184]

Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@dogarluqman7671]

@@vincentchung8184 i want contact

[@oooferdick2773]

Since 2014 AUgust this started NO SPECIALIST HAS BEEN ABLE TO IDENTIFY MY E.T

[@ruthmarymccarterbogue1925]

So far I have had no help. I've been DX'd with Neural Myoclonus. He sed "incurable" but he hasn't even approached the tremor. I may have to approach it with more "push" it is really bad at times..hold that coffee with 2 hands,etc. writing is a joke. My hubby has taken over the writing aspect.

[@jannelee299]

I have head tremor for more than 10yrs ang progresses last year. Iam 44 years old - Philippines

[@JaneSmith-dj5dl]

Eat a healthy diet helps alot.. Mediterranean diet! Drink Alot of water Less sugar drinks and not drink coffee Getting some sun everyday helps and walking... Anything good for the nervous system is good

[@tranphuongthao8965]

Have you cured it ?

[@vincentchung8184]

Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@johnjuicehealthy479]

I’m hand only shake when I’m writing ✍️ why??

[@EssentialTremorIETF]

ET is an action tremor, which means it shows itself when you are trying to perform a task such as write, eat, brush your teeth, etc.

[@timrgemini]

@@EssentialTremorIETF I have action tremors and at-rest tremors. The at-rest tremors are worse when I am trying to sleep...especially as I transition into, and out of, sleep.

[@vincentchung8184]

@@timrgemini Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@vincentchung8184]

Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@chetanrs]

@@EssentialTremorIETF can an argumentative/anxious situation with someone lead to ET ? To be more specific -- I was arguing quite loudly overy the phone and my heart was also racing -- the moment I hung up, I could see my left hand (wrist-up) shaking vigorously. I've had such severity two times this year

[@AexoeroV]

My head tremors made my life a living hell. Im an alcoholic cause i couldn't do anything without alcohol and my benzos. At 43 i live with my parents and i cant do nothing, i have anxiety too and this conditions "mix well". My head starts to tremor even at low emotional states, i couldn't even do my driving license, im nobody and i dont know how i will end up. I seen my life pass by me not been able to take advantage of its good parts.

[@johnhariis250]

You're 43? I'm 66 and was only diagnosed last year I've been down that road Yeah Sure the Alcohol settles the nerves My writing is pretty much gone Great education we're all getting here I wish you all well

[@AexoeroV]

@@johnhariis250 yeah, some of us are "blessed" with this illness from younger age. My head started to shake when i was 16-17 years old, it wasn't as bad as now though. Do you take some medicine that works?

[@jackyblair9880]

Both my children have it and it is hard to see them struggle at times BUT I know the God has a plan for them. You have your parents. That in itself is a blessing... They got your back :)

[@AexoeroV]

@@jackyblair9880 Im sorry to hear about your childrens and its good that you can believe that God has some good plan etc. I have my parents and they are good parents but they are old and with their own problems, i should be on my own and living my life and not to be a hassle for them at my age. And when i will be alone i will be probably miserable, good plan had God for me!

[@Xanax1.0]

Does benzos help u

[@kimwright8795]

Doctor says i dont have parkinson

[@user-sj3uz8qt7y]

My name is Bakary jatta am suffering from essential tremor I need help pliz

[@EssentialTremorIETF]

Have you seen a neurologist? Take a look at our patient handbook online for more information about essential tremor. essentialtremor.org/wp-content/uploads/2022/09/PatientHandbook2022-web-Final.pdf

[@user-xz7xt4kq6p]

Yarn over purl to knit

[@luxaca3340]

I lost every quality i have nothing left to lose i can't do a simple task

[@ellenreynolds8665]

Lucaca, I have ET but not in hands but extensive everywhere else. I’m 78 years & condition getting very bothersome & debilitating so I understand how you feel. I’m saddened by your remarks & feel your distress. What medicines & treatment have you tried? I assume yours is action tremor?

[@vincentchung8184]

Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@kevincarstairs9227]

I was diagnosed with no- no symptoms familiar essential tremors when I was 7 to 8 years I’m 53 I ask a doctor to help with my head tremors he say have a drink it help I get stop by cops because my head tremors they think I’m a crackhead I don’t do drugs I only drink to help in I live in Canada in Canada it’s not under disorder in Canada

[@sivajisrk]

Best drug for Head tremor?

[@EssentialTremorIETF]

Here is an article that gives an overview of head tremor and some ways to manage it. essentialtremor.org/wrapping-your-mind-around-head-tremor/

[@bryanjohnson9109]

Pure CBD oils control my vocal chords better than botox or any of the medications I've tried over 50 years. I wish there was a trial for that.

[@EssentialTremorIETF]

The IETF provided a research grant for a study in this area. We are expecting results to be published within the next couple of months. Watch our social media and website for information.

[@angeluser4699]

It's great for my voice

[@jeffmcelroy3261]

What oils do you use?

[@gowthami7701]

Iam Gowthami actually iam suffering from essential tremors since my childhood & iam very sad 😔 due to this

[@dhandekrushna4055]

Are you from india

[@gowthami7701]

@@dhandekrushna4055 yes

[@daviddalton8341]

I can't say I'm sad about it but I've had a tremor since age 13 but never formally diagnosed

[@kath3611]

me too but God's grace is here always! My great friends are very supportive, I try to remember there are MANY people who are worse off and thank God for all of the blessings.

[@nurofenaddict5905]

i was givin propranolol 40 mgs

[@edwinplaza2927]

I use the same but 160 extended release. That's because have hypertension too. Also take primidone.

[@vincentchung8184]

Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@vincentchung8184]

@@edwinplaza2927 Hi my name is Vincent. I'm a computer science students and I currently doing some research about detecting tremor disease. I need a lot of people to do some easy to do physical test and drawing. I really need a lot of dataset and if you would like to help me you can contact me through my university email which is [e-mail] and I can give you the instruction. Would really appreciate your help.

[@sarahlyons2341]

I'm currently on propranolol at 20mgs and it isn't helping at all still. Is the 40mg helping you and how long did it take for you to get to that dose?

[@nurofenaddict5905]

@@sarahlyons2341 it takes 2 weeks