Essential & Familial Tremors

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Essential and familial tremor specialists on Houston Methodist’s integrated neurology team implement the most advanced technology and treatments to manage the intrusive symptoms of these complex movement disorders.

Houston Methodist neurologists are national leaders in essential and familial tremor diagnosis, treatment and research. Our patients have access to leading-edge therapies not widely available at other health care centers.

Essential and familial tremor can closely resemble Parkinson’s disease. It is a genetic mutation and if present in one parent, there is 50% chance of passing it on to children. Aside from the genetic component, its cause is unknown.

Our integrated specialists understand the nuances of essential and familial tremors — we will provide an accurate diagnosis and treatment plan that reduces your symptoms, improving your quality of life.   

Depending upon your symptoms, your care team will partner with you to ensure optimal effectiveness of your treatment throughout all stages of your disorder.

Diagnosing & Treating Tremors

How are essential and familial tremors diagnosed?

The first step in diagnosing essential tremors is to rule out other conditions that may be causing your symptoms. Our expert team will meet with you to discuss your personal and family medical history, as well as how your symptoms affect daily life. 

Then, we will perform neurological and physical exams to assess your tendon reflexes, muscle tone and strength, ability to feel certain sensations, posture, coordination and gait. Our specialists will ask you to demonstrate how well you can drink from a glass, hold your arms outstretched, write and draw a spiral. 

These exams help us identify three distinct factors that differ between tremor and Parkinson’s disease: 


  • Essential tremor typically involves the hands, head and voice. Parkinson’s disease tremors can affect other parts of the body.
  • In the hands, essential tremor usually occurs during use. Parkinson’s disease tremors can occur at rest.
  • Essential tremor does not cause other health conditions or problems, whereas Parkinson’s disease can cause stooped posture and gait problems.


We also will test your blood and urine for factors that can contribute to symptoms, such as thyroid disease, metabolic conditions or substance interactions.

What treatment options are available?

Patients with mild symptoms may not require medical treatment. However, behavioral modifications can help reduce the severity and progression of symptoms:


  • Reducing or eliminating alcohol and caffeine
  • Using heavier glasses and eating utensils
  • Wearing wrist weights
  • Writing with wider pens or pencils
  • Practicing mindfulness to reduce stress and anxiety


For moderate to severe symptoms, we offer a range of comprehensive treatment options:


  • Medications – Beta blockers, anti-seizure and epilepsy drugs or tranquilizers can help some types of essential or familial tremors.
  • Procedures – Botulinum toxin (Botox®) injections can reduce nerve impulses that result in tremors in certain areas of the body. Deep brain stimulation (DBS) is a surgical option in which a thin probe is inserted into your thalamus and connected to a neurostimulator device implanted in your chest. The device sends electrical impulses that interrupt the signals that cause tremors.
  • Therapy – Physical or occupational therapy can help improve your ability to perform daily tasks.

I need advanced care or a second opinion.

Houston Methodist is your partner in making treatment decisions. Our recommendations are based on years of experience in diagnosing and treating tremor disorders. We educate patients and families on comprehensive treatment options, including clinical trial therapies that are not yet widely available at other centers.  

Essential and familial tremor symptoms can change over time. Our neurologists are part of a multidisciplinary team that tailors care plans to every patient’s unique condition.

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Houston Methodist is leading the way in new research to find innovative treatment options.

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