Do You Shake? Essential Tremor Used to Be Called Benign Familial Tremor - The Scoop

Coping is the Norm

Millions of people, like me, my sister, and my grandmother shake all the time. Only 10% of them seek medical attention. For me, essential tremor (ET) means people think I'm nervous when I'm fine. ET means having to lean over my bowl of soup to get a spoonful to my mouth without spilling soup in my lap. If I get angry or afraid, I actually quake. When I used to sew up lacerations of skin, though, my work was unaffected. I got great cosmetic results. This is born out by practicing neurosurgeons who have learned to compensate for their tremors.

Essential tremor does tend to run in families. It can come on at any age including childhood. It tends to worsen and may get coarser with advancing age. You can see this age effect in Kathryn Hepburn in "On Golden Pond." This tremor can affect arms, legs, head, and voice. Alcohol lessens the shaking. No one knows the exact cause, but the fact that deep brain stimulation (a last resort surgical operation in severe cases) works to quiet ET is telling of an origin in the brain.

The International Essential Tremor Foundation ( offers information and helpful gadgets such as plates with bumpers. They are also advocating for an Essential Tremor Awareness Month to be designated by the U.S. congress.

Caffeine and nicotine worsen this tremor. Relaxation, meditation, and other stress reduction techniques may help.

The first-line meds for folks who decide they'd be happier with less tremor are inderal (a BP med), mysoline (a seizure med), and topiramate (a migraine treatment). Sometimes helpful is gabapentin, another seizure drug. It takes fairly high doses to improve ET, so side effects are an issue. Sometimes a combination is used to minimize side effects. Benzodiazepines such as Ativan and Klonopin are effective, but not the drugs of choice as they are addictive. As mentioned above, alcohol is effective and a couple drinks can be used to lessen ET for a special occasion. Alcohol is not recommended as a long-term treatment as it has lead to alcoholism in ET sufferers.

As of 2016, a new procedure is available for severe ET. High intensity ultrasound waves destroy one side of the thalamus (a communication center in the brain). Tremor tends to be improved to the point where quality of life is improved. It, however, is irreversible and can be associated with side effects such as gait disturbances.

I have been asked if I have Parkinson's Disease. I'm sure I don't. Parkinson's tremor occurs at rest and is accompanied by muscle stiffness and slowness. Essential tremor occurs while holding a posture or moving and has no accompanying symptoms.

Another common type of tremor is enhanced physiological tremor. Causes include overactive thyroid, medications (including antihistamines, lithium, and antipsychotics), muscle fatigue, and anxiety.

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Comments 24 comments

diogenes profile image

diogenes 6 years ago from UK and Mexico

Interesting. Some medications may also cause or worsen this? I have a friend on anti-depressants whose hands have begun to shake...I don't think it can all be caused by excitement at seeing me! Bob

Me Too 6 years ago

I sometimes take Modafinil. It definitely increases the shaking. On the other hand Modafinil shows positive effects in Parkinson's patients against nerve degeneration.

cathylynn99 profile image

cathylynn99 6 years ago from northeastern US Author

sorry, Diogenes. I wasn't clear. i edited the hub to show that meds cause a different kind of tremor - enhanced physiological, which can occur on its own or make ET worse.

yes, Me Too, stimulants can cause or exacerbate tremor.

Steven Levine 6 years ago

I find your mention of "practicing neurosurgeons who have learned to compensate for their tremors" to be very interesting. I've had E.T. since childhood, and I'm unable to drink coffee in public (except in a travel mug), and yet I'm able to type 36 wpm using only six fingers, which is quite amazing.

cathylynn99 profile image

cathylynn99 6 years ago from northeastern US Author

bravo to you, steven. sounds like you're more than a survivor, more like a champion. thanks for the travel mug coping tip, too.

Steven Levine 6 years ago

Thanks for the kudos, cathylynn99 (this site needs a button). I'd be more of a survivor and a champion if I were employed and not borderline indigent, but I guess that's off topic.

You can thank my sister for the travel mug idea. She got it for me a couple years ago, and it has been a great relief, along with a Tupperware-type container with tight-fitting lid for carrying soup, etc.

Steven Levine 6 years ago

(above message was supposed to say "a 'Like' button." I put the word between less than/greater than symbols (as I commonly do on Facebook), and apparently it got stripped as being bad HTML.)

cathylynn99 profile image

cathylynn99 6 years ago from northeastern US Author

if you like the hub, hit the "up" button at the end of the hub. it's like thumbs up. well, employed or not, you are contributing tips that will help others. are you on "linked in", the internet employment network? you could register on hubpages and write here, too. i've yet to make money here, but it's a good outlet. oh, there is a link to facebook with a "like" button at the top af the hub, at least there is on mine.

Happyboomernurse profile image

Happyboomernurse 6 years ago from South Carolina

I had tremors when I was in my twenties, thirties and forties, but rarely have them anymore. They seemed to be related to anxiety and stress and through the decades I've learned how to cope with stress and anxiety by using meditation, physical excercise and limiting caffeine intake.

Thanks for sharing this informative article.

magnoliazz profile image

magnoliazz 6 years ago from Wisconsin

ETs run in my family also, I remember Aunt Mabel shook all the time... she was a great source of interest to us when we were small children.

Excellent hub!

cathylynn99 profile image

cathylynn99 6 years ago from northeastern US Author

dear happyboomernurse,

sounds like you had enhanced physiological tremor caused by anxiety. your common sense measures will help others.

dear magnoliazz,

thanks for the compliment and especially for reading

cathylynn99 profile image

cathylynn99 5 years ago from northeastern US Author

March 2011 is the first ever national essential tremor awareness month.

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Liasis1 5 years ago from Nashville

My husband has ES, it runs in the males in his family.

Recently I began seeing a neurosurgeon who is now running a pain clinic. He's a well-respected dr, even was on-call physician to a few presidents. On my first visit he dxd me with Sticky Blood & told me I was on the verge of another stroke. Lab tests bore his dx out. I mentioned my husband's tremor to him & he asked to see him.

Today my husband saw Dr Y for the first time. He was amazed at the way this dr could tell him about his symptoms before he ever mentioned them!

My husband is bipolar & takes saphris, which Dr. Y told him to stop immediately. He (my husband) is on all kinds of other meds, cholesterol, triglyceride, bipolar & blood pressure. He was told by his PCP that Inderal (I took it to prevent migraines, it was a nightmare med for me) would interact badly with his other meds, so now it seems to be a choice between tremors or high triglyceride.

Also, he has noticed the tremors are worse on his dominant side (he's left-handed), & is learning to eat with his right hand. It actually seems to be working well for him.

cathylynn99 profile image

cathylynn99 5 years ago from northeastern US Author

there's still mysoline and topiramate or even the occasional ativan for a special function (say a speech or a daughter's wedding). otherwise, coping, as it sounds he is creatively doing, is a good strategy.

thanks for reading.

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Ginger Ruffles 4 years ago

Informative hub. Runs in our family as well. It's so important to know that a Parkinson's tremor occurs at rest while ET occurs when trying to do something.

Also if you need a Neurologist please get a MD referral from the ET Foundation. Too many doctor's are unknowledgeable about this condition and will diagnose this as Parkinson's as my elderly father has been. Trust me it's a nightmare you don't want or need.

cathylynn99 profile image

cathylynn99 4 years ago from northeastern US Author

thanks, ginger.

i wouldn't let anyone diagnose me with parkinsons. i'm far too assertive and knowledgeable. it's good advice in general, though. thanks again.

chefsref profile image

chefsref 3 years ago from Citra Florida

Good Hub.

I seem to have some ET in my family. I remember when my grandmother was alive, if she drank a cup of coffee the cup would actually rattle against her teeth. I thought it was funny as a kid but now I must have inherited it. At times it is very difficult to sign my name legibly.

cathylynn99 profile image

cathylynn99 3 years ago from northeastern US Author

hi, chefsref,

yep, good that they took benign out of the name, because this tremor can cause significant problems. thanks for reading and commenting.

Marie Flint profile image

Marie Flint 3 years ago from Jacksonville, FL

I personally never had a tremor problem. My father-in-law, however, had signs of it and he took his wife's valium to lessen the shakes. (I reprimanded him for using others' medications, but it didn't o any good; he also kept drugs way beyond their expiration date.)

I think mental types are more prone to this problem, perhaps. Has anyone tried going entirely organic with their diet?


cathylynn99 profile image

cathylynn99 3 years ago from northeastern US Author

essential tremor is not associated with any mental illness.

techygran profile image

techygran 2 years ago from Vancouver Island, Canada

cathylynn99 thank you for a very clearly-written and easy-to-understand article about a condition that I personally see more and more often among friends and acquaintances in my 'boomer' generation. I had always assumed that the tremor WAS Parkinsons until a close friend described his struggles with ET. He was a celebrated church organist and now, as he heads towards 70, contents himself with frustrating sessions on his livingroom organ only. It's a shame.

I think an awareness "day" is a great idea because I am guessing that Essential Tremors are pretty wide-spread and misunderstood as our populations age.

Thank you for posting this valuable hub. ~Cynthia

cathylynn99 profile image

cathylynn99 2 years ago from northeastern US Author

thanks for reading and commenting, cynthia.

Kristina 2 years ago

Thank you once again Rebecca. Very helpful. When we first decosverid the first lump on her right thigh, we scheduled surgery immediately to have it removed and, while prepping for surgery, our primary vet found several other lumps and referred us to an oncologist instead of trying to remove everything. When we first saw the oncologist, she did an initial ultrasound to see if the cancer had spread internally, but there was nothing visible. We went through three kinds of chemo, she took prednisone throughout (which caused her to have muscle wasting and pant/pee constantly), benadryl, pepcid, and all kinds of other supplements (K9 Immunity Plus being one of the primary ones.) By the time the tremors got really bad, our strong Boo girl had been through so much we decided not to haul her out to the specialty hospital to have an MRI. We never consulted with a neurologist because we knew that s/he would order unpleasant tests and the prognosis was already poor with the cancer. Plus, I had read many articles about idiopathic tremors and had the impression that even if extensive testing was done there isn't a whole lot that can be done. Then, almost overnight, the tumors started growing very quickly all over her body. On her last day, her left ear flopped over and was twitching. She was losing control over her body, piece by piece. I'm with you my gut told me that the tremors were related to the cancer and it had spread to her brain. In all my reading on mast cell cancer, I did not read anything about the link with calcium levels and am most grateful for that information. It will go into my brain vault and I will share it with others! Much appreciation again, Elizabeth

Gracelin 2 years ago

And I thought I was the sensible one. Thanks for setting me stitgrha.

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