Overview Of The Causes And Complications Of Essential Tremor

November 14, 2023

Essential tremor is a movement disorder where a patient experiences involuntary shaking with a rhythmic motion. It appears most often in their hands. This condition is different from a tremor that occurs as a complication of another disorder or head trauma. Other neurological symptoms occur alongside essential tremor as they do with a tremor that has other causes. Essential tremor is most prominent when affected individuals move and perform different activities, such as drinking, eating, and writing. This condition is also noticeable when the patient is extending the affected part of their body and the muscles they are using are opposing gravity. Aside from the hands and arms, essential tremor can occur in the trunk, head, face, and neck.

Unfortunately, there is no essential tremor cure. However, there are many available treatments for essential tremor. Many patients will need prescription medicine for essential tremor, such as seizure medication, beta-blockers, and benzodiazepines. Essential tremor natural treatment often includes physical and occupational therapy to learn adapted ways to complete basic tasks. It is worth noting, though, that some individuals will need surgery for essential tremor. Of course, they must understand the causes and complications of this condition first.

Genetic Mutation

Half of all essential tremor patients have a genetic mutation that has caused them to develop it. An individual born to a parent with essential tremor has a fifty percent chance of inheriting the genetic mutation responsible. However, not everyone affected by associated genetic mutations will develop symptoms of essential tremor. The genetic mutations most often associated with essential tremor are those that occur on an individual's LINGO1, ETM1, ETM2, ETM3, FUS, SLC1A2 HS1-BP3, and TLS genes. This mutation is inherited in an autosomal dominant manner in most cases.

Usually, there is no correlation between the severity and age of onset of essential tremor that runs within a family. Most individuals affected by a familial form of essential tremor have developed it due to their genetic abnormality and other environmental risk factors that have either triggered or activated the abnormal gene in their body.

Older Age

Older individuals are more likely to develop symptoms of essential tremor. Despite this, essential tremor is not a part of the natural aging process. The first symptoms of essential tremor do not manifest in most patients until the fourth or fifth decade of their life. Around four percent of individuals who are forty years old or older are affected by some tremors. The mean age of affected individuals at the time of their first symptoms is between thirty-five and forty-five years old.

Most individuals who will develop essential tremor will see symptoms by sixty-five years old and most definitely by seventy years old. There is a negative correlation between the severity and frequency of essential tremor as it progresses over time. The severity of essential tremor tends to worsen as patients age. In contrast, the frequency of their tremor episodes tends to decrease as they age. It is rare for essential tremor to be seen in children, newborns, and infants.

Lack Of Sleep

Evidence shows that patients experience fewer symptoms of essential tremor when they rest. Unfortunately, sleep and rest can be quite difficult with this condition, particularly when patients are also dealing with significant anxiety and stress. Studies show that a lack of sleep can trigger severe episodes of essential tremor. It can also cause a patient's symptoms to worsen overall. A lack of sleep often results in fatigue, which also makes it harder for the patient to control their symptoms. When patients are fatigued, the energy they do have is automatically directed to basic needs to keep their body functioning. Stopping a tremor in the hands, for instance, is not needed to keep the body running.

Excessive Caffeine Consumption

Healthy individuals who drink significant amounts of caffeine often deal with temporary tremors in their hands. This is often referred to as 'caffeine jitters,' since it is one of the associated side effects. Excessive caffeine consumption is also a significant trigger for essential tremor. In many cases, it will worsen the patient's symptoms significantly. It will often do this much faster than it would if they did not have essential tremor. Furthermore, excessive caffeine consumption often results in a lack of sleep. As discussed, this can also exacerbate the symptoms of essential tremor.


Evidence indicates that excessive exercise can worsen a patient's essential tremor symptoms. In most cases, this appears to happen because patients after left quite fatigued after exercise, and their body does not have the energy it needs to control the tremors better. High intensity interval training is a type of exercise that is particularly exhausting. Thus, it makes worsened essential tremor symptoms more common. Despite the risk of worsened symptoms after intense exercise, not all forms of exercise are causes of essential tremor. Some patients, for example, benefit from strengthening exercises given to them by a physical therapist.

Issues With Eating

Issues with eating arise when essential tremor becomes severe enough to interfere with the patient's ability to hold and use eating utensils to bring food from the dish to their mouth. This type of difficulty occurs most often in patients who have an essential tremor that mainly affects the muscles in their arms and hands. As it gets harder to control movements enough to use utensils to eat, a patient's diet may change if they do not have anyone with them to help them eat. These diet changes include a general reduction in the frequency of meals and the amount of food being consumed.

Foods that do not require utensils to eat are often not as healthy and nutritious as foods that do require utensils. Additionally, an individual may refuse to eat in social settings if they are embarrassed about essential tremor. They may then have issues maintaining an appropriate caloric intake and deal with weight loss.

Issues With Holding Objects

Issues with holding objects are common among patients who have essential tremor in the muscles of their hands or arms. Episodes of periodic uncontrollable shaking occur in the hands. They are most prevalent when the affected individual is trying to hold something or use their muscles to perform a task. Attempting to produce a targeted movement with the hands when holding an object can trigger essential tremor symptoms. As this complication becomes more severe over time, it can interfere with the patient's ability to perform daily tasks and take basic care of themselves. The patient may begin to neglect their dental health because brushing their teeth and flossing becomes too difficult to carry out.

An individual may choose to wear clothing that does not have any button or fastening mechanism because securing these components becomes too hard. In addition, a patient's caloric intake may begin to suffer because holding and using utensils becomes challenging. An affected individual may also avoid tasks involving handwriting. The reason is that it often gets harder to hold and manipulate a pen or pencil.

Stress And Anxiety

Stress and anxiety share close connections to essential tremor. In most cases, essential tremor will cause patients significant stress and anxiety about controlling their symptoms. This is what will often classify them as a complication. Essential tremor can be quite frustrating, especially if patients have not found the right treatment for their needs. However, in other instances, stress and anxiety can be a cause of essential tremor. This does not apply to temporary stress from a particular event. It is chronic stress and anxiety that can sometimes result in an individual developing essential tremor. They will often worsen a patient's condition as well.


Unfortunately, irritability has multiple connections to essential tremor. It can cause a patient's symptoms to worsen, similar to the way in which stress does. Another way to consider it is that many individuals start to shake when they are frustrated. In addition, many patients can experience increased irritability as a complication of their condition. In this case, individuals are often irritated about their inability to stop their tremors. Stress and irritability often coincide as well, which is why it is common to see both of these as essential tremor complications and triggers.

Speech Problems

Essential tremor patients may develop speech problems as they age and their condition progresses over time. The exact mechanism that causes speech problems in essential tremor is not clear. However, it is thought to be closely associated with the development of tremors in the larynx. The larynx, also called the voice box, is a component of the respiratory tract that encompasses the vocal cords. It is located in between the trachea and pharynx. The vocal cords are the two bands of muscle that form a 'V' shape in the larynx. They are the structures responsible for the production of sound.

When an individual speaks, their vocal cords move closer together and tighten. When they are not speaking, their vocal cords relax and move further apart. An essential tremor patient may exhibit a quivering sound in their voice when they speak. This is a result of involuntary rhythmic muscle movements that affect the vocal cords. The volume and or pitch of an affected individual's voice may change. They may experience interruptions in vocal sound production with tremors in their vocal cords. In rare cases, a tremor in the abdominal, chest, or mouth muscles may be responsible for speech problems associated with essential tremor.

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