Tremors are rhythmic and involuntary movements of a part of the body. The most common triggers of tremors include neurological conditions, cerebellar disorders, metabolic disorders, stroke, side-effects of certain medications, alcohol withdrawal, and stress. This blog focuses on the clinical nuances of tremors with particular emphasis on neurological disorders, Essential Tremor and Parkinson’s disease, the two prominent contributors of tremors.
Let’s explore the differences between Essential Tremor and Parkinson’s Tremor, while also understanding their symptoms, causes, and other critical features that help in arriving at an accurate analysis and effective management.
Understanding Essential Tremor
Essential Tremor (ET) is a neurological disorder that is characterized by involuntary and rhythmic shaking of certain body parts. ET mostly manifests in the hands, head, and voice. It is often progressive and can impact daily activities, affecting quality of life. Although ET is not associated with other neurological symptoms (dementia, for example), it can be functionally disabling, without leading to cognitive impairment.
Essential Tremor Causes and Symptoms
Often referred to as “benign”, ET predominantly manifests as rhythmic shaking, typically affecting the hands. Some individuals can experience a tremor in the head. This is often mistaken for a nodding and shaking motion.
Other aspects that ET can affect include posture and voice.
Stress can exacerbate the symptoms of ET. although it can extend to other parts of the body. The tremors are often noticeable during purposeful movements and may worsen with stress, fatigue, or certain postures.
It may be difficult to pinpoint an exact cause of ET. However, studies have shown ET may be triggered by a combination of the following:
- Family history
- Brain abnormalities (especially in the cerebellum, thalamus, and/or other motor control regions)
- Environmental factors (caffeine, smoking, emotional stress, fatigue)
- Side-effects of certain medications
- Age
- Neurotransmitter imbalance (especially gamma-aminobutyric acid, GABA, which regulates nerve impulses)
What is Parkinson’s Tremor?
Parkinson’s disease is a progressive, chronic, and degenerative brain disorder that impairs muscle control, balance, and movement. It results in the deterioration of the cells in substantia nigra (in the basal ganglia). It disrupts the brain’s ability to produce dopamine, the happy hormone. As the disease progresses, the neurons in the brain completely deteriorate.
In its advanced stages, Parkinson’s can lead to severe motor impairment, tremor, stiffness, slowed or delayed movement, dysphagia, sleep issues, fatigue, difficulty in speech, etc.
Parkinson’s Tremor is a distinct type of tremor, and is often referred to as resting tremor.
Unlike Essential Tremor, the tremors associated with Parkinson’s are more pronounced at rest and tend to diminish during purposeful movements.
Essential Tremor vs. Parkinson’s Tremor
| Feature | Essential Tremor (ET) | Parkinson’s Tremor (PT) |
| When Tremor Occurs | Primarily during action (e.g., writing, holding objects) | Most evident when the affected limb is at rest |
| Posture & Balance | Normal posture, balance usually preserved | Often accompanied by postural instability |
| Other Symptoms | Generally limited to tremor | May include shuffling gait and other Parkinson’s symptoms |
Diagnosing Tremor
The following steps may be followed by your doctor to arrive at a diagnosis.
Clinical Evaluation
Your doctor may assess patient history, family history, and conduct a detailed examination of tremor characteristics.
Neurological Examination
A thorough neurological exam helps differentiate between tremor types, assess muscle tone, reflexes, coordination, gait, and detect other signs suggestive of conditions like Parkinson’s disease.
Neuroimaging
Typically, an MRI (magnetic resonance imaging) or DaTscan is used to rule out other potential causes and provide additional insights into the underlying pathology.
Managing Tremor
| Condition | Management Approach | Key Interventions |
| Essential Tremor (ET) | Combination of lifestyle modifications and medications | – Beta-blockers
– Anticonvulsant drugs |
| Parkinson’s Disease | Holistic, customized rehabilitation programs offered at Plexus centers in Bangalore and Hyderabad | – Cell therapy
– Occupational therapy – Physical therapy – Speech and language therapy – Cognitive rehabilitation therapy – Bradykinesia management – Rigidity management – Agility training – Functional training – Hand function training and more |
Living with Tremors
Both Essential Tremor and Parkinson’s Tremor have numerous psychosocial implications. Since both types of tremors are visible, it can make the patient feel extremely self-conscious, and even impact everyday functionality.
Adaptive devices, occupational therapy, and participation in support groups are considered great coping strategies. However, a great component of coping with tremor is the patient’s social environment. Having family, friends, and co-workers who are supportive and understanding can go a long way in helping these patients come to terms with their diagnosis, and navigate the many challenges that accompany tremor disorders.
At Plexus, we offer a wide range of therapies and rehabilitation programs for both Parkinson’s and Essential Tremor.
If you wish to know more about these, please do not hesitate to reach out to our team in Bangalore and/or Hyderabad.
WhatsApp +91 89048 42087
Call +91 78159 64668 (Hyderabad) | +91 82299 99888 (Bangalore)
FAQs
1. Does Essential Tremor eventually lead to Parkinson’s disease?
No, Essential Tremor does not cause Parkinson’s, though some people may develop both conditions over time.
2. At what stage do tremors begin in Parkinson’s disease?
Tremors often appear in the early stages, sometimes as the first noticeable symptom.
3. How do Essential Tremors differ in speed from Parkinson’s Tremors?
Essential Tremors are usually faster (4–12 Hz) compared to Parkinson’s Tremors, which are slower (4–6 Hz).
4. What exercises are good for Essential Tremors?
Hand-strengthening exercises, light weights, coordination drills, yoga, and stress-reducing activities can help.
5. Can vitamins help reduce tremors?
Vitamins don’t cure tremors, but B12, magnesium, and vitamin D may support nerve and muscle health—always under medical advice.
About the Author
Dr. Na’eem Sadiq
Medical Director of Plexus
Dr. Na’eem Sadiq is a globally recognized neurologist and neuropsychiatrist, renowned for his contributions to the treatment of complex neurological disorders. He founded Plexus in 2011 with a mission to enhance the quality of life for patients living with neurological conditions.
With over 35 years of clinical experience, Dr. Sadiq is considered a leading expert in the field. His internationally acclaimed research spans key topics such as Demyelinating Polyneuropathy, Multiple Sclerosis, Epilepsy, and Migraine, positioning him at the forefront of neurological care worldwide.
