Howard M. Eisenberg, MD, and the UMMC neurology team discuss the benefits of MRI-guided focused ultrasound in treating essential tremor.

Essential tremor is an uncontrollable, rhythmic shaking. It can interfere with daily tasks like eating, writing or holding a tablet. 

Essential tremor is the most common movement disorder, affecting 10 million Americans.

Getting Help for Essential Tremor at UMMC

Our specialists are at the forefront of advanced treatments for essential tremor. We can help manage the symptoms and, in some cases, significantly reduce the shaking people experience. 

We provide a personalized approach to essential tremor treatment using the most current and advanced tools available. While we offer a range of treatments including medication and deep brain stimulation (DBS), we also utilize cutting-edge technologies such as MRI-guided focused ultrasound (FUS). This FDA-approved, noninvasive procedure is part of our comprehensive suite of options, allowing us to tailor treatment plans to each patient's unique needs.

Call 410-328-8008 to learn more about getting essential tremor care at UMMC.

Symptoms of Essential Tremor

In addition to involuntary movement in the hands and arms, essential tremor can also affect:

  • Your head, causing uncontrollable "yes-yes" or "no-no" head-shaking movements
  • Your voice, causing it to tremble and fluctuate in volume
Essential tremor symptoms are often mistaken for Parkinson’s disease. But there are key differences:
  • Symptoms of essential tremor occur during action while maintaining a position and not at rest, while Parkinson’s symptoms do occur at rest. In fact, essential tremor tends to be worse during movement. 
  • Essential tremor movement is a faster, more confined motion, while Parkinson’s movements are slower and longer. 

What Causes Essential Tremor

In about half the cases, essential tremor symptoms are attributed to a genetic mutation that can be passed down within families. Researchers are unsure of the causes in other cases. 

The risk of developing essential tremor increases as you get older. It is not considered a dangerous neurological (nervous system) disorder, but it can worsen over time and greatly affect your quality of life.

Making a Diagnosis

There is no definitive test for essential tremor. It can be hard to diagnose because it is often mistaken for Parkinson’s disease, but doctors can look for small differences.

To make a diagnosis, doctors will: 

  • Review your medical and family history
  • Conduct a physical examination
  • Conduct a neurological examination that includes assessments of coordination, balance, strength, reflexes and movement
  • Run lab tests to rule out other conditions that may be causing your symptoms

Treatment for Essential Tremor

There are a few options for people with essential tremor: 

Medication – As a first step, your doctor may prescribe a medication, such as propranolol, to control your essential tremor symptoms. Sometimes after taking the drug for a while, your body may develop a tolerance to it, making it less effective. 

Deep Brain Stimulation -– Deep brain stimulation has been the standard of essential tremor care for more than 25 years. DBS involves using electrical stimulation to control abnormal brain signals linked to ET symptoms. This technique requires surgeons to implant electrodes into the brain through a tiny opening in the skull. These electrodes connect to a battery-operated generator typically positioned under the collarbone, with wires running beneath the skin. DBS has been shown to help ET symptoms and can be adjusted over time. Learn more about deep brain stimulation and how it can help.

MRI-Guided Focused Ultrasound – this is an advanced technology only offered at a few hospitals in the United States. Focused ultrasound is limited in invasiveness and can significantly help tremor in some ET patients. UMMC conducted the groundbreaking research that led to FUS becoming FDA approved to treat essential tremor. Learn more about how FUS works

Make an Appointment

If you or your loved one has essential tremor, call us at 410-328-8008 to make an appointment with one of our specialists.