Essential Tremor - Signs and Symptoms

Signs and Symptoms

Essential tremor generally presents as a rhythmic tremor (4–12 Hz) that is present only when the affected muscle is exerting effort (in other words, it is not present at rest). Any sort of physical or mental stress will tend to make the tremor worse, often creating the false impression that the tremor is of psychosomatic origin.

Tremor intensity can worsen in response to fatigue, strong emotions, low blood sugar, cold, caffeine, lithium salts, some antidepressants or other factors. It is typical for the tremor to worsen in "performance" situations, such as when writing a cheque for payment at a store or giving a presentation.

ET-related tremors do not occur during sleep, but patients sometimes complain of an especially coarse tremor upon awakening that becomes noticeably less coarse within the first few minutes of wakefulness.

In mild cases, ET can manifest as the inability to stop the tongue or hands from shaking, the ability to sing only in vibrato, and difficulty to do small precise tasks such as threading a needle. Even simple tasks like cutting in a straight line or using a ruler can range from difficult to impossible, depending on the severity of the condition. In disabling cases, ET can interfere with a person's ability to perform tasks of daily living, including feeding, dressing, and activities of personal hygiene.

People with ET can sometimes have problems with word finding and can't articulate themselves effectively even with preparation. A person with ET may become shy, withdrawn, pessimistic, anxious and also have difficulties concentrating. It is common for those with ET to be embarrassed by the condition even though it is out of their control.

ET is generally progressive in most cases (sometimes rapidly, sometimes very slowly), and can be disabling in severe cases.