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Essential tremor

  • Alternative Names

    Tremor - essential; Familial tremor; Tremor - familial


    Treatment may not be needed unless the tremors interfere with your daily activities or cause embarrassment.


    For tremors made worse by stress, try techniques that help you relax. For tremors of any cause, avoid caffeine and get enough sleep.

    For tremors caused or made worse by a medication, talk to your doctor about stopping the drug, reducing the dosage, or switching. Do NOT change or stop medications on your own.

    Severe tremors may make it harder to do daily activities. You may need help with these activities. Devices may help with everyday activities, such as:

    Buying clothes with Velcro fasteners, using button hooks

    Cooking or eating with utensils that have a larger handle

    Using straws to drink

    Wearing slip-on shoes and using shoehorns


    Medicines may help relieve symptoms. The most commonly used drugs include:

    • Propranolol, a beta blocker
    • Primidone, a drug used to treat seizures

    The drugs can have side effects.

    • Propranolol may cause fatigue, stuffy nose, or slow heart beat, and may make asthma worse
    • Primidone may cause drowsiness, problems concentrating, nausea, and problems with walking, balance, and coordination.

    Other medications that may reduce tremors include:

    • Antiseizure drugs such as gabapentin and topiramate
    • Mild tranquilizers such as alprazolam or clonazepam
    • Blood pressure drugs called calcium-channel blockers such as flunarizine and nimodipine

    Botox injections, given in the hand, have been used to reduce tremors by weakening local muscles.


    In severe cases, surgery may be tried. This may include:

    • Focusing high-powered x-rays on a small area of the brain (stereotactic radiosurgery)
    • Implanting a stimulating device in the brain to signals the area that controls movement

    Support Groups

    Expectations (prognosis)

    An essential tremor is not a dangerous problem, but some patients find the tremors annoying and embarrassing. In some cases, it may be dramatic enough to interfere with work, writing, eating, or drinking.


    Sometimes the tremors affect the voice box, which occasionally leads to speech problems.

    Calling your health care provider

    Call for your health care provider if

    • You a have a new tremor
    • Your tremor makes it hard to perform daily activities
    • You have side effects from in the drugs used to treat your tremor