Essential tremor is one of the most common neurologic conditions in the world. It consists of a trembling or shaking that worsens over time, and it can affect patients at almost any age in life. It is usually brought out by holding a posture or making purposeful movements. The most common parts of the body to be affected are the arms (especially the hands), but the legs, head, trunk, and voice can also be involved.
Tremor is not a dangerous condition, but it can interfere with a person’s life. It may make everyday activities very difficult: eating and drinking, typing, knitting, putting on clothing, or performing other dexterous activities. Tremor can also cause social anxiety, if, for example, you are prone to spilling food or drink in public. Fortunately, there are a variety of medications that can be effective in controlling tremor, including beta blockers (e.g. propranolol) and primidone.
Medications do not provide enough relief for every tremor patient, and for some people, tremor can be disabling. For patients with tremor who have bothersome symptoms despite trials of at least two medicines, surgery should be considered.
There are two surgeries for essential tremor. I discuss both of them with every patient, and there are advantages and disadvantages to each.