If you’ve been diagnosed with essential tremor, The University of Michigan Health System Movement Disorder Program offers the latest nonsurgical and surgical therapies delivered by a medical team who are leaders in their fields. We treat between 400 and 500 essential tremor patients every year. Our neurologists have specialized training in the evaluation and treatment of this condition and our Surgical Therapies Improving Movement (STIM) program is home to one of the largest deep brain stimulation centers in the Midwest region.
Essential tremor, also known as familial tremor, is the most common movement disorder, affecting an estimated 5 percent of people worldwide. It can affect people of any age and tends to run in families. The tremor is usually in the hands and arms but can also be in the head, voice, chin, trunk and legs. Both sides of the body tend to be equally affected. The condition is characterized by action tremors, meaning the tremors are noticeable when the affected area is moving, but improve when at rest. Most people seek treatment when the condition begins to interfere with their quality of life. Many primary care physicians can diagnose and treat this condition. However, if the diagnosis is in doubt, or if your medications are not working optimally, you may need to see a neurologist.
On your first visit, our neurologists will conduct a thorough history and neurological examination. We look at the tremors, what situations they occur in, which medications might cause them and at thyroid function. We may also take images of your brain.
The first line of treatments for essential tremor is medications, such as propranolol and primidone. Many people will see some improvement from the medications, although they may not make the tremors go away completely. When essential tremor is interfering with quality of life and medications aren’t working, surgery is an option.
Deep brain stimulation is the most commonly-performed surgery for essential tremor and is highly effective. U-M’s STIM program is responsible for evaluating and treating tremor patients with deep brain stimulation. Our multidisciplinary evaluation program includes members from neurology, neurosurgery, psychology, psychiatry, speech pathology, radiology and social work. We believe the comprehensive nature of our program, unique in Michigan, leads to better patient outcomes.
Deep brain stimulation involves placing an electrode in a structure of the brain called the thalamus. It is typically placed on one side of the head, and connected by a wire that runs underneath the skin to a battery in the chest. When electrical stimulation is delivered to the brain, the tremor improves. It’s like a pacemaker for the brain, instead of the heart. Deep brain stimulation has several advantages over ablation (where cells in the brain are destroyed), including reversibility. At U-M, we have developed a wide array of ways to improve DBS, including special imaging tools that help doctors more accurately place the electrodes, and intraoperative motor and speech testing that result in fewer side effects for the patient.
We are also actively researching new ways to treat essential tremor, including a current study of a noninvasive device that can help control tremors and allows those with the condition to manage daily tasks, such as eating, without medication or surgery.