I sometimes have a slight tremor when I'm at rest that increases when I'm doing something precise. And sometimes i forget silly stuff like taking a shower or talking to someone. could it be serious?
Initially, causes of enhanced physiologic tremor, including medications, stimulants such as caffeine, hyperthyroidism (over-active thyroid gland, usually associated with heat intolerance, unintended weight loss, dry skin etc.), fever, and anxiety, should be excluded.
Otherwise, we usually think of an entity known as essential tremor, which is by far the most common movement disorder. It is a syndrome of unknown etiology characterized by a slowly progressive tremor that occurs at rest (postural) and/or with movement (kinetic), usually affecting both upper extremities. Some believe it is more prevalent in timid individuals.
The following characteristics can be noted in patients with essential tremor:
- A family history of essential tremor is noted in 50-60% of cases
- Tremor usually begins in one upper extremity and soon affects the other; essential tremor rarely extends from the upper extremity to the leg on the same side of the body
- A mild degree of asymmetry in the severity or extent of the tremor is expected
- In about 30% of cases, the muscles that cover the head are affected; the head is involved most frequently, followed by voice, jaw, and face
- Tremor may occur on and off initially then becomes persistent over time
- At any point in time, the frequency of the tremor is relatively fixed
- The amplitude of the tremor is influenced by the state of emotional activation; tremor amplitude is worsened by emotion, hunger, fatigue, and temperature extremes
- The baseline tremor amplitude slowly increases over several years
- The patient is typically capable of voluntarily controlling the tremor, and the tremor may be suppressed by skilled manual tasks
- The tremor resolves during sleep
- Ethanol intake temporarily reduces tremor amplitude in an estimated 50-70% of cases
Essential tremor has been hypothesized to be a risk factor for the development of Parkinson disease, but no association exists between essential tremor and memory problems.
As for therapy, usually people with essential tremor find a way to overcome and live with this benign symptom. Otherwise, two medications, primidone and propranolol, would be the best choice of medical therapy for essential tremor. These medications provide good benefit, reducing tremor amplitude in approximately 50-70% of patients.
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