What is essential tremor, how to differentiate its symptoms from Parkinson's | Health - Hindustan Times

What is essential tremor and how to differentiate its symptoms from Parkinson's disease

By, New Delhi
Aug 10, 2023 06:06 PM IST

Essential tremor is a neurological disorder characterized by involuntary and rhythmic shaking of certain parts of the body.

Essential tremor, a neurological disorder, can cause involuntary and rhythmic shaking of body parts while doing small tasks like tying shoelaces or holding a glass of water, and can worsen as one ages. Hand shaking, head shaking or voice issues are reported in this disorder. Apart from tremors, there can be slowness of movement, muscle stiffness, balance issues and rigidity. There can be numbness or tingling in certain body parts. The nervous system disorder is often confused with similar and more commonly discussed conditions like Parkinson's disease. While it can co-exist with Parkinson's, it is a standalone disorder. Essential tremor is more common after the age of 40 but can affect people of any age. It doesn't cause any serious health issues unlike Parkinson's but people suffering from it may have an unsteady walk. (Also read: Tips for patients and caregivers on living well with Parkinson's disease)

 Essential tremors can vary in severity, ranging from mild to debilitating, and they tend to worsen with age.(Freepik)
Essential tremors can vary in severity, ranging from mild to debilitating, and they tend to worsen with age.(Freepik)

Dr. Vishal Chafale, Consultant Interventional Neurologist, Apollo Hospitals Navi Mumbai in an interview with HT Digital answers important questions about Essential Tremor be it symptoms, similar conditions, causes, treatment and lifestyle changes.

Hindustan Times - your fastest source for breaking news! Read now.

What are essential tremors?

Essential tremor, often referred to as ET, is a neurological disorder characterized by involuntary and rhythmic shaking of certain parts of the body, especially the hands. It is one of the most common movement disorders, affecting millions of people worldwide. Essential tremors can vary in severity, ranging from mild to debilitating, and they tend to worsen with age.

• Involuntary shaking of hands, arms, head, or other parts of the body.

• Tremors are typically symmetrical and affect both sides of the body.

• Tremors at rest, which means shaking occurs when the affected body part is relaxed and not in use.

• Muscle stiffness, balance issues and rigidity.

• Bradykinesia, or slowness of movement.

• Numbness or tingling in various parts of the body.

• Blurred or double vision.

• Sudden weakness or numbness, especially on one side of the body.

• Sudden trouble speaking or understanding speech.

• Muscle tension and trembling.

When to worry

If you or someone you know experiences any of the following, it's crucial to seek immediate medical attention:

Sudden onset: Any sudden and severe onset of symptoms, such as weakness on one side of the body, slurred speech, or severe headaches, could be signs of a medical emergency like a stroke or brain-related issue.

Rapid progression: If the symptoms rapidly worsen or progress, it may indicate a more serious condition that requires prompt evaluation.

Associated symptoms: The presence of other concerning symptoms, such as loss of consciousness, difficulty breathing, or severe pain, may warrant immediate medical attention.

Impact on daily life: If the symptoms significantly interfere with daily activities or quality of life, seeking medical evaluation is essential.

Telltale signs of essential tremors

Tremor during movement

The hallmark sign of essential tremor is the presence of involuntary shaking that occurs during voluntary movements, such as when reaching for objects, writing, or performing fine motor tasks.

Bilateral and symmetrical tremors

Essential tremor typically affects both sides of the body symmetrically. For instance, if the right hand is affected, the left hand will likely exhibit similar tremors.

Postural tremor

The tremors are often more noticeable when assuming a posture against gravity, such as holding the arms outstretched or when standing.

Absence of resting tremor

Unlike Parkinson's disease, essential tremor usually does not involve tremors when the affected body part is at rest.

Variable severity

The intensity of the tremors may vary throughout the day and can be influenced by factors like stress, fatigue, or caffeine intake.

Progressive worsening

Essential tremor can progress over time, becoming more pronounced as individuals age.

Improvement with alcohol

Some individuals with essential tremors may experience temporary relief from their tremors after consuming small amounts of alcohol, although this effect varies between individuals and is not recommended as a treatment.

Essential tremor vs Parkinson's disease

Essential tremor is a neurological disorder, and while it is often considered an isolated condition, it can be associated with certain other diseases or conditions.

Essential tremor and Parkinson's disease are both movement disorders, and it is possible for individuals to have symptoms of both conditions simultaneously. However, it's important to note that they are distinct disorders with different characteristics. While essential tremor is primarily characterized by postural and action tremors, Parkinson's disease is characterized by resting tremors, muscle stiffness, bradykinesia (slowness of movement), and postural instability.

Some of the other diseases that may be linked to essential tremor include:

Dystonia: Dystonia is another movement disorder that can sometimes coexist with essential tremor. Dystonia causes involuntary muscle contractions that lead to repetitive or twisting movements and abnormal postures.

Multiple Sclerosis (MS): Essential tremor and MS are two different neurological conditions that can occur together. MS is an autoimmune disorder that affects the central nervous system, leading to a wide range of symptoms, including tremors.

Anxiety disorders: Anxiety disorders such as generalized anxiety disorder (GAD), can sometimes exacerbate essential tremor symptoms. Stress and anxiety can make the tremors more noticeable and difficult to control.

What are the causes and treatment?


Genetics: Essential tremor often runs in families, indicating a genetic component. Certain genes may play a role in its development, though the specific genes involved are not yet fully identified.

Abnormal brain function: Essential tremor is thought to result from abnormal communication between certain areas of the brain, particularly the cerebellum (responsible for coordination and motor control) and other parts of the brain involved in motor functions.

Neurotransmitter imbalance: Imbalances in neurotransmitters, the chemical messengers in the brain, may also contribute to essential tremor.

Environmental factors: Environmental factors, such as exposure to toxins or certain medications, may trigger or worsen essential tremors in some individuals.


The treatment of essential tremors aims to manage and reduce the severity of tremors, improve the individual's quality of life, and enhance their ability to perform daily activities.

Medications: Certain medications can help reduce tremors by affecting neurotransmitters in the brain. The most commonly prescribed drugs for essential tremor include beta-blockers (e.g., propranolol) and anti-seizure medications (e.g., primidone). These medications can be effective in mild to moderate cases.

Botox injections: In some cases, botulinum toxin (Botox) injections can be used to reduce tremors, particularly in the hands. Botox works by temporarily blocking nerve signals to the affected muscles, reducing their involuntary movements.

Deep brain stimulation (DBS): DBS is a surgical procedure where electrodes are implanted in specific areas of the brain responsible for tremors. These electrodes deliver electrical impulses to regulate abnormal brain activity and reduce tremors. DBS is usually recommended for severe and medication-resistant essential tremor cases.

New emerging modality of treatment: This is a non-invasive treatment that uses high-intensity focused ultrasound waves to target and destroy specific brain tissue responsible for the tremors. It can provide significant relief for essential tremor patients who do not respond well to medications.

Lifestyle changes: Avoiding stimulants like caffeine and getting enough rest can help reduce tremor severity. Stress management techniques, such as meditation or yoga, may also be beneficial.

Physical therapy: Occupational and physical therapy can help individuals with essential tremor learn techniques to improve their fine motor skills and perform daily tasks more effectively.

Supportive devices: Devices like weighted utensils, adaptive equipment, or wrist braces can assist individuals in managing essential tremors and performing daily activities more easily.

Catch your daily dose of Fashion, Health, Festivals, Travel, Relationship, Recipe and all the other Latest Lifestyle News on Hindustan Times Website and APPs
Share this article
Story Saved
Live Score
Saved Articles
My Reads
Sign out
New Delhi 0C
Wednesday, February 28, 2024
Start 14 Days Free Trial Subscribe Now
Follow Us On