Signs and Symptoms of Essential Tremor

Most people think that essential tremor is limited only to the presence of tremor in hands. However, there are some other symptoms that develop during the course of the disease. Most often, we undermine these symptoms that can also bother the patient’s daily life. Here, you’ll get to know all the important signs and symptoms of essential tremor.

Essential tremor (ET) is a neurological condition that causes involuntary shaking or trembling. There are millions of people suffering from this condition. In the USA, almost 10 million people are living with ET. It mostly affects people at 40 or above, although it can appear at any age. 

Here are the most common signs and symptoms of ET that you need to know!

1. Tremor 

This is the primary symptom of ET. It is characterized by uncontrollable and rhythmic shaking of the hands. It usually appears on one hand and then gradually affects the other hand. Besides hands, the tremor can also affect body parts like the head, tongue, and jaw. 

The tremor progresses over time and its intensity can vary. Sometimes, it is mild; other times, it is fast and gets worse, especially when a person experiences stress or fever. It becomes fast when the hands perform different activities; for example eating, drinking, or writing. And it is absent when the hands are at rest.

It can also happen when the hands are extended or when a person consumes caffeine. 

2. Impaired Gate

Although undermined for many years, the impaired gate is now considered as one of the key symptoms in ET. Like tremor, it can also bother the patient’s daily life.

A simple method used to assess the gait problem in ET is the tandem walk, also called the heel-to-toe walk. In this method, a patient is asked to walk in the straight line with one foot in front of the other: in a way that the heel of one foot touches the toe of the other. 

The patient usually shows an abnormality in the tandem gate with an increased number of mis-steps. 

3. Cognitive Disturbances

ET causes changes in cognition. During the course of the disease, a patient shows impair attention and has a problem in naming and recalling words. The patient may also have a problem in working memory, which helps in learning and performing basic tasks.

Most often this aspect of the disease does not get enough attention from the caregiver and family members. Unfortunately, it is also sometimes underestimated by neurologists. This’s why this feature of the disease is overlooked and remains untreated. 

4. Personality Changes

Essential tremor can also cause personality changes. The patient becomes more anxious and experiences excessive worrying and harm avoidance. The patient may also show controlled behavior, and tends to be kinder, more tender‐minded, and less aggressive than healthy people. 

5. Sleep Disturbance

Sleep disturbance is one of the most common non-motor signs that appear in ET. People with ET are frequently reported to have poor sleep quality. They also tend to sleep more during the day. The excessive daytime somnolence is often linked to the side effects of medication used to treat ET. 

Some patients may also experience REM sleep (rapid eye movement), during which the eyes move rapidly in different directions and the heart rate and breathing become faster. 

6. Loss of Smell

Loss of smell is also considered one of the signs of ET. However, this sign of the disease is not very common. It is usually modest, and its appearance depends on the type and severity of the tremor. It can be more common in the late-onset of ET. 

7. Hearing Loss

People with ET have a problem with hearing, which is sometimes ignored not only by family members but also doctors at the time of diagnosis. 

Over 30% of ET patients are reported to have hearing loss. This is especially in those patients who are above the age of 65.

While it is not clear why the loss of hearing appears in ET, researchers have increasingly realized that there is a strong connection between the two. 

8. Depression

Depression was once considered a secondary symptom in ET and was thought to be a response to tremor. But now it is realized that it is the underlying disease process rather than the consequence of tremor. 

A study conducted in China concluded that over 54% of ET patients are suffering from depression-like symptoms. 

When not treated properly, depression can affect the patient’s quality of life and further deteriorates ET.

9. Fatigue

This sign of the disease is not frequently reported and is usually considered the side effects of medication. However, it could also be one of the signs of ET.

Fatigue doesn’t appear alone and is usually not linked to tremor severity. But it does appear when other non-motor symptoms like depression, anxiety, and sleep problem are present. Researchers think that this may result from a lack of sleep or when a patient is depressed

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