Essential Tremor

BJC HealthCare works with WashU Medicine, BJC Medical Group, and providers across the region to deliver exceptional care.  Our movement disorder specialists use the latest technologies to provide effective essential tremor treatment. WashU Medicine’s research efforts allow us to continually provide innovative care as new treatments are discovered.

You benefit from:

• Leading-edge treatments: WashU Medicine physicians at Barnes-Jewish Hospital are the only in Missouri to offer high-intensity focused ultrasound (HiFu), an incisionless surgery that treats essential tremor. We can offer the most advanced drugs available for the treatment of essential tremor, including those approved by the FDA and those approved for clinical trial.
• Multispecialty team: We offer a multidisciplinary approach to care by bringing together a team of experts to treat your individual needs safely and effectively. Your team includes physicians, nurses, physical therapists, occupational therapists, speech therapists, dietitians, and pharmacists working together to create a comprehensive treatment plan. These experts include nationally recognized subspecialists in movement disorders, such as essential tremor, who are known for treating complex cases.
• Personalized care: Our personalized approach to care ensures that your physical, emotional, and spiritual needs are met in the most coordinated, compassionate manner possible. 

Essential tremor is a neurological condition in which tremors or shakes occur without an identifiable cause. The shaking occurs when a person is moving or trying to move, but not while they are at rest. Some degree of tremor is normal for everyone, but in essential tremor patients the shaking may start in one part of the body and progress to include other parts, such as the hands, arms, head, voice box, eyelids, or other muscles. 

An accurate diagnosis is the first step toward treatment. Essential tremor can be easily misdiagnosed as Parkinson’s disease. Our specialists have the expertise to deliver a precise diagnosis, which is crucial, because there are multiple types of essential tremor, and the types can differ in their response to treatment.

The process to diagnose essential tremor can include a full examination and a complete review of medical and family history, as the condition often runs in families.

Other tests may include:

• Tests of muscle tone, coordination, and balance
• Memory test
• Speech test
• Medical scans, such as an MRI or computed tomography (CT) scan, to rule out other possible causes of the tremor 

You may not require treatment if you have a mild essential tremor. But when a tremor interferes with your ability to do everyday tasks, or if symptoms have become a burden, we can help. Our goal is to reduce your symptoms so you can do all the things you love. We offer a variety of treatments that we can customize for your individualized care plan. 

Treatments may include:

• Medicine: Some antianxiety or anti-seizure medicines can help lessen tremor symptoms.
• Botulinum toxin: This therapy involves injecting medicine into muscles affected by tremors to reduce shaking.  
• High-intensity focused ultrasound: High-intensity focused ultrasound (HiFu) is a nonsurgical treatment for patients who have not responded to medicine. It uses soundwaves guided by an MRI to treat deep in the brain with no incision or permanent implants. WashU Medicine physicians and Barnes-Jewish Hospital are the only Missouri to offer this treatment for essential tremor.
• Deep brain stimulation (DBS): Deep brain stimulation is a surgical procedure that inserts electrodes into your brain and an electrical device into your chest. The devices work together to stimulate nerves in the brain to interrupt tremor activity.
• Therapy services: Occupational therapy and speech therapy can enhance your independence and reduce the impact of tremors. Therapy services include voice stabilization, task-modification strategies, and training in the use of weighted adaptive tools.
• Lifestyle modifications: Being overtired or stressed can make essential tremor symptoms worse. Getting good sleep, managing stress, and avoiding stimulants, such as caffeine and nicotine, can help manage symptoms.