Benign Essential Tremor Syndrome

Definition

Definition of Benign Essential Tremor Syndrome
Benign Essential Tremor is a neurologic movement disorder characterized by involuntary fine rhythmic tremor of a body part or parts, primarily the hands and arms (upper limbs). In many affected individuals, upper limb tremor may occur as an isolated finding. However, in others, tremor may gradually involve other anatomic regions, such as the head, voice, tongue, or roof of the mouth (palate), leading to difficulties articulating speech (dysarthria). Less commonly, tremor may affect muscles of the trunk or legs.

Symptoms

Symptoms of Benign Essential Tremor Syndrome
Common symptoms of benign essential tremor syndrome include mild to moderate tremors and fine shaking movements. Tremors in the arms, head or voice may occur while moving or while at rest. Tremors may worsen with stress, emotion, fatigue, and exposure to cold. Tremors usually worsen with movement.

Causes

Causes of Benign Essential Tremor Syndrome
Benign Essential Tremor is generally considered a slowly progressive disorder. Disease progression is characterized by an increase in tremor amplitude, causing difficulties in performing fine motor skills and varying degrees of functional disability. For example, hand tremor may gradually cause difficulties with manipulating small objects, drinking fluids from a glass, eating, writing, or dressing. (As mentioned above, in some affected individuals, disease progression may also include extension of tremor to other muscle groups.)

Diagnosis

Diagnosis of Benign Essential Tremor Syndrome
Usually the diagnosis is established on clinical grounds. Tremors can start at any age, from birth through advanced ages (senile tremor). Any voluntary muscle in the body may be affected, although the tremor is most commonly seen in the hands and arms and slightly less commonly in the neck (causing the patient's head to shake), tongue, and legs. A resting tremor of the hands is sometimes present.

Treatment

Treatment of Benign Essential Tremor Syndrome
Drug treatment of the tremors may include tranquilizers, beta-blockers, and antiepileptic drugs. Surgical treatments, generally reserved for the most severe cases, include botulism toxin injections into the affected muscles, pallidotomy, thalamotomy, and deep brain stimulation wherein a pacemaker is inserted into the brain. The medications that are prescribed the most for control of ET symptoms are the anticonvulsant Primidone (or Mysoline) and the beta-blocker propranolol (or Inderal). Less severe cases of ET can be treated with physical therapy and development of the muscles in the sections of the body that are affected and are severe in their shaking. Other potential sources of tremor, such as excessive caffeine consumption, medications, recreational drug use, and hyperthyroidism, should be excluded if possible.

Prognosis

Prognosis of Benign Essential Tremor Syndrome
Consult with your doctor.

Prevention

Prevention of Benign Essential Tremor Syndrome
Consult with your doctor.