Essential Tremor Diagnosis Guide

January 21, 2021

Experiencing the onset of persistent trembling or shakiness due to tremor can be unsettling. The severity of tremor can vary. For example, your tremor may be mild and only noticeable during certain activities like tying your shoelaces. Or, you might have more severe symptoms that negatively impact your ability to function and complete tasks like eating or writing.

Tremor can be caused by a variety of health conditions and lifestyle choices. But in this article, we’ll dive more deeply into the most common movement disorder, essential tremor or ET. Essential tremor is also called benign tremor — but despite the “benign” in the name, the condition can still affect a patient’s quality of life. Although ET isn’t considered life-threatening, it can become disabling in severe cases. And some patients with essential tremor might feel stressed, anxious, or embarrassed about their tremor, which can lead to worsening of symptoms.

If you want to learn more about the diagnosis of essential tremor, keep reading for a full explanation. Or, you can skip to the section you want to read by using the navigation links below.

Contents

What is Essential Tremor?

How is Essential Tremor Diagnosed?

Cala Trio and Essential Tremor

Writing in a notebook

What is Essential Tremor?

Essential tremor is a movement disorder that’s most commonly found in older adults aged 65 years or older. According to Johns Hopkins Medicine, symptoms of essential tremor may include the following:

  • Tremors happen during movement and are less noticeable or stop when the hands are at  rest
  • Tremors might improve with a small amount of alcohol ingestion
  • Medications, caffeine, and stress may worsen tremor
  • Tremors progress in severity as you get older
  • Tremor typically doesn’t affect both sides of your body the same way
  • Shaky hands, head, torso, legs, or an unstable gait
  • Difficulty completing tasks like applying makeup, picking up a water glass, or writing
  • A quivering voice

How is Essential Tremor Diagnosed?

Essential tremor diagnosis can be a long process since doctors typically need to rule out other health conditions before arriving at a  diagnosis of ET.  The diagnostic process is complicated by the fact that researchers, doctors, and scientists aren’t sure what the exact cause of essential tremor is, especially when a patient has no family history.

In the disease state essential tremor, a patient experiences action tremors. This type of tremor happens when you’re voluntarily using a muscle to complete a certain movement. So, for example, lifting up a water glass could exacerbate a mild tremor. Action tremors can be further divided into subcategories that include kinetic, isometric, and postural tremor. For further resources on different types of tremors, you can read the Tremor Fact Sheet published by the National Institute of Neurological Disorders and Stroke.

The severity of tremor is another factor your healthcare provider will take into consideration during diagnostic testing and evaluation. Your physician will note the amplitude of shaking, frequency of tremor, and which body parts the tremor affects.

Family history also comes into play as an important diagnostic criterion. If essential tremor is part of your family’s medical history, you are more likely to develop tremor. If your parent has essential tremor, for instance, there’s a 50% chance that you and your siblings will also have this disorder.

Neurological Examination

Your physician will likely conduct a series of tests to evaluate the functioning of your nervous system as it relates to your tremor and overall health. A doctor will test things such as your ability to feel different sensations, deep tendon reflexes, muscle strength, motor function, and coordination.

Testing reflexes

Laboratory Tests

Lab testing is another important aspect of essential tremor diagnosis. Here are a few tests your doctor might order if your family history and physical examination are inconclusive: liver function, serum ceruloplasmin (Wilson’s disease screening), blood urea nitrogen, creatinine levels, and thyroid function.

These lab tests can reveal underlying health conditions that might be the cause of a patient’s tremor symptoms.

Imaging Studies

In order to rule out neurodegenerative diseases, like multiple sclerosis which causes brain lesions, a doctor may require you to undergo certain imaging studies like a CT scan or MRI. Imaging can reveal abnormalities in the brain that might be causing tremor symptoms along with other health conditions.

Brain scans

Performance Tests

A performance test can’t be used in isolation to definitively diagnose essential tremor, but these tests provide your doctor with critical information about your specific tremor.

Tasks you might be asked to complete include the Archimedes’ Spiral Test, drinking from a glass, writing a sentence, or holding your arms out in front of your body.

Used performance tests in conjunction with other diagnostic exams, a doctor can develop a better understanding of the severity and type of tremor you have. It’s important to understand that the diagnostic process can take months or even years in some cases. However, if you’ve developed a tremor, it’s always a good strategy to consult with a doctor, even if your tremor is mild. A mild tremor can be due to essential tremor, or it can be a sign of a more serious health issue.

Older couple out hiking in the mountains

Cala Trio and Essential Tremor

Although lifestyle modifications, surgery, and medications are all possible treatment options, patients with essential tremor now have a new therapy to consider: Cala Trio. The Cala Trio is a specialized, FDA-cleared medical device that sends electrical pulses to the brain to disrupt the network responsible for tremor. This wristband is calibrated to match your unique tremor pattern, which can potentially provide you with customized relief and a higher quality of life. Ask your doctor about your essential tremor treatment options and Cala Trio today.