Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
Tags: essential | tremor | treatement | drugs | hands | shaking

What Causes Essential Tremor?

Monday, 10 September 2012 10:06 AM

Question: What can be done for someone suffering from essential tremor? What is the cause?

Dr. Hibberd's answer:
Essential tremor is very common and is a type of involuntary shaking movement, usually in the hands, in which no cause can be identified. It is often a familial trait. Tremors can be worsened by stress and some medications (such as sudafed or other phenylephrine or epinephrine-like agents).
Most treatment plans to manage essential tremors are quite simple and include a correction of sleep habits, and eliminating precipitating drugs or supplements, especially avoiding caffeine, stimulants, appetite suppressants, and psychoactive drugs, whether prescription or obtained otherwise. The condition may be misdiagnosed as Parkinson's disease, which shows itself as a very different kind of tremor. Adequate sleep and correction of poor dietary habits will help some, while others may need help with medications.
Medications such very as low-dose beta blockers (inderal or propranolol) are often useful. Sometimes an anticonvulsant medication (such as topamax, or neurontin) may help. None of these medications completely treat essential tremor, and all may cause side effects.
In exceptional cases, Botulinum toxin (Botox) injections may help those with selected severe and continuous intractible tremor.
Physical and occupational therapy may help you better perform tasks that are affected by essential tremor. Here are coping strategies that are effective for some sufferers:
• Avoid foods that contain caffeine, like sodas, coffee, tea, and chocolate.
• Place a napkin between cup and saucer to avoid rattling when lifting to drink.
• Use a straw to drink.
• Auto-dial or use voice dialing while using a cellphone instead of trying to hit the individual numbers.

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The cause of essential tremor is unknown and it is treated in a variety of ways.
Monday, 10 September 2012 10:06 AM
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