Essential tremor is a relatively common condition it does seem to have a familial basis. About half the patients who present with essential tremor have a family history of essential tremor – a tremor often that starts in younger life – late teens, early 20s. Patients notice that when they’re putting their hands up or doing something, it becomes a more and more vigorous tremor movement. Often this is brought out by actions like carrying a cup and saucer, or carrying a drink for example, and spilling it.

It generally affects both sides of the body. It can affect the head and also the voice – so you can get a bit of a shake in the voice. Interestingly. it doesn’t seem to be a disease of degeneration, so cells aren’t dying in the brain. So the symptoms generally stay stable throughout life and we have some good treatments to reduce the amount of tremor that patients have.

In terms of what causes it, we’re not entirely sure and certainly under the microscope there don’t seem to be abnormalities of the brain. we see this thought that perhaps there’s an abnormal circuit in the brain and the treatments don’t often target that circuit – they often target the nerve impulses to the muscle.

The commonest way for us to treat this is with an old-fashioned beta-blocker drug. These are the drugs that the heart doctors used to calm your heart down lower your blood pressure in your pulse. Where we see it working with essential tremor is that it stops the signaling between the nerves and the muscles and dampens down that tremor. Interesting to know that these tablets of course are banned substances for certain sports, where they might need very fine control – like golf or playing snooker. So for someone with essential tremor it’s important they recognise that it’s something that doesn’t get worse over time and generally responds well to treatments, with no pathology in the brain.