How do I know if I have Essential Tremor?

Essential Tremor is a neurological condition characterized by rhythmic shaking, typically occurring during intentional movement or when holding a posture, such as extending your arms. If you notice shaking that interferes with daily tasks like writing, drinking from a glass, or buttoning a shirt, it is important to consult a physician to differentiate Essential Tremor from other movement disorders.

What are the early signs of Essential Tremor?

The hallmark of Essential Tremor is a "kinetic" or "action" tremor, meaning it appears when you use your hands. Unlike tremors seen in Parkinson’s disease, which often occur at rest, Essential Tremor symptoms typically improve when the limb is fully relaxed. Early signs often manifest as subtle shaking in one or both hands, which may gradually progress to involve the head, voice, or legs over many years.

How can I perform a self-assessment for Essential Tremor?

To identify potential symptoms of Essential Tremor, observe your movements during these specific activities:

• The Pouring Test: Does your hand shake significantly when pouring water from a pitcher into a glass?


• The Writing Test: Does your handwriting become shaky, larger, or more jagged than it used to be?


• The Holding Test: Extend your arms straight out in front of you; does a rhythmic tremor appear or worsen after a few seconds?


• The Spoon Test: Do you struggle to keep food on a spoon while bringing it to your mouth?

When should I see a doctor and what tests are used?

You should schedule an appointment if your tremors cause social embarrassment or difficulty with activities of daily living. There is no single blood test for Essential Tremor; diagnosis is clinical, based on your medical history and a physical examination. Ask your doctor about a neurological exam to rule out other conditions like hyperthyroidism or medication-induced tremors. If you feel dismissed, advocate for a referral to a movement disorder specialist, as they have the specific expertise to accurately diagnose Essential Tremor.

What are the red flags requiring urgent evaluation?

Seek immediate medical attention if you experience tremors accompanied by sudden weakness, numbness, difficulty speaking, significant balance issues, or if the tremor begins abruptly on only one side of the body. These "red flags" are not typical of Essential Tremor and require investigation for other neurological conditions.

Next steps

• Keep a symptom log noting when the tremor occurs and what makes it better or worse.


• Connect with the 62 members of the Essential Tremor community at DiseaseMaps.org to share experiences.


• Consult a neurologist, specifically one specializing in movement disorders.

Medical disclaimer: This content is for informational purposes only and does not constitute professional medical advice, diagnosis, or treatment.

References

• NIH Genetic and Rare Diseases Information Center (GARD): Essential Tremor


• International Essential Tremor Foundation (IETF)


• Orphanet: Essential Tremor


• Movement Disorder Society: Clinical Diagnostic Criteria