Essential Tremor: Symptoms, Causes, and Concerns

Q: Essential Tremor: Symptoms, Causes, and Concerns

Hello： Based on your description, primary tremor is primarily a symptom caused by instability in muscle coordination. <br>Generally, physicians may prescribe Propranolol to stabilize the symptoms. <br>This medication works by reducing sympathetic nervous system activity. <br>Our

Tremors and muscle twitching?

Hello Doctor: Recently, I have noticed that my hands are trembling.
After an examination at a large hospital, the doctor told me it is essential tremor.
However, I learned that essential tremor is often hereditary, but my parents don't seem to have any tremors.
After a week, I received my blood test results, and the doctor said my thyroid is normal.
I would like to ask if this really confirms that it is essential tremor.
Recently, I have also noticed some muscle twitching in my limbs and lips, occurring for about 1-3 seconds, happening around 10 times a day.
So far, it hasn't affected my daily life; I walk and ride my bike normally, and I don't feel any weakness in my limbs.
I tend to be more sensitive and often think the worst.
Doctor, should I be concerned about this?

Xiao Zhu, 20~29 year old female. Ask Date: 2018/07/28

Dr. Jiang Junyi reply Neurology

Hello: Based on your description, primary tremor is primarily a symptom caused by instability in muscle coordination.
Generally, physicians may prescribe Propranolol to stabilize the symptoms.
This medication works by reducing sympathetic nervous system activity.
Our autonomic nervous system is regulated by the sympathetic and parasympathetic nervous systems, with one acting as the accelerator and the other as the brake.
The sympathetic nervous system is responsible for stimulating the body, leading to increased heart rate, faster breathing, and increased sweating.
Once the activity stops, the parasympathetic nervous system takes over, slowing down the heart rate, reducing breathing rate, and decreasing sweating.
Therefore, many conditions that increase sympathetic nervous system activity can exacerbate tremor symptoms, such as consuming caffeinated beverages or experiencing poor sleep.
When treating tremors, it is essential to check for abnormalities in thyroid function or electrolytes.
I recommend discussing testing and treatment options with your primary care physician.
Wishing you good health, peace, and joy.
Dr.
Jiang, Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2018/07/28

More Info

Essential tremor (ET) is a common movement disorder characterized by involuntary shaking, most often affecting the hands, but it can also involve the head, voice, and other parts of the body. It is important to understand the symptoms, causes, and concerns associated with this condition, especially in light of your recent experiences.

Symptoms of Essential Tremor
The primary symptom of essential tremor is rhythmic shaking, which can vary in severity. In your case, you mentioned that your hands shake, which is typical for ET. Other symptoms may include:
- Tremors that worsen with movement or when trying to hold a position (postural tremor).

- Tremors that may improve with alcohol consumption, which is a unique characteristic of ET.

- Tremors that can affect the voice, leading to a shaky or quavering sound.

- In some cases, tremors may also be accompanied by muscle twitching or spasms, which you have described as muscle movements in your limbs and lips.

Causes of Essential Tremor
The exact cause of essential tremor is not fully understood, but it is believed to involve genetic factors, as it often runs in families. However, not all individuals with a family history will develop the condition, and conversely, some may develop it without any known family history. Since you mentioned that your parents do not exhibit tremors, it is possible that your condition is sporadic rather than hereditary.

Other potential causes of tremors can include:
- Thyroid disorders (which you have ruled out through testing).

- Neurological conditions, such as Parkinson's disease, although the tremors in ET are typically different in nature.

- Certain medications or substances, including caffeine, which can exacerbate tremors.

Concerns and Management
Given that your tremors have not significantly impacted your daily life and you are able to walk and ride a bike normally, it is a positive sign. However, the presence of muscle twitching can be concerning, and it is essential to monitor these symptoms. Muscle twitching, or fasciculations, can occur for various reasons, including stress, fatigue, or benign conditions such as benign fasciculation syndrome.

Since you identify as a sensitive person who tends to worry about serious outcomes, it is crucial to manage anxiety and stress, as these can exacerbate tremors and muscle twitching. Here are some recommendations:
1. Consult a Specialist: If you have not already, consider seeing a neurologist who specializes in movement disorders. They can provide a more comprehensive evaluation and confirm the diagnosis of essential tremor.

2. Lifestyle Modifications: Reducing caffeine intake, managing stress through relaxation techniques (such as yoga or meditation), and ensuring adequate sleep can help alleviate symptoms.

3. Medication: If the tremors become more bothersome, medications such as beta-blockers (e.g., propranolol) or anticonvulsants (e.g., primidone) may be prescribed to help control the tremors.

4. Support Groups: Connecting with others who have essential tremor can provide emotional support and practical coping strategies.

In conclusion, while your symptoms align with essential tremor, it is essential to continue monitoring your condition and maintain open communication with your healthcare provider. If your symptoms worsen or begin to affect your quality of life, further evaluation and treatment options should be considered. Remember, managing anxiety and stress is equally important in dealing with any chronic condition.

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