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Essential tremor & dystonia

Tremor essentialis et dystonia · Esenciální tremor a dystonie

What it is

The commonest movement disorders after Parkinson's: a shaking that appears with action, or muscles pulled into postures.

Symptoms & signs

  • Tremor when holding or doing, not at rest
  • worse with stress or caffeine
  • often better with alcohol
  • twisting neck or eye closure in dystonia

🚩 Get help if…

  • call 112 / 911 now Sudden neck or jaw spasm, eyes stuck upward or trouble breathing after a new drug
  • see a doctor soon Tremor that starts suddenly or on one side only
  • see a doctor soon Tremor with slowness, stiffness or shuffling steps
  • see a doctor soon Tremor with weight loss, sweating or a racing heart

Where it strikes

Medical treatment

  • Propranolol or primidone
  • botulinum toxin for dystonia and head tremor
  • deep brain stimulation
  • focused ultrasound thalamotomy

Natural & lifestyle

  • Caffeine reduction
  • weighted utensils
  • stress management
  • sleep
  • alcohol is not a treatment

Emerging & experimental

  • Adaptive deep brain stimulation

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Stabilising spoons and weighted gloves — studies show better eating and writing mixed evidence
  • Octanoic acid — small trials early / small studies
  • Cannabis — a small trial found no effect on tremor not confirmed in trials

ICD codes