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Condition

Essential tremor specialist in the Bay Area

Essential tremor is one of the most common movement disorders. It causes shaking of both hands and arms during actions such as writing, eating or holding a cup, and can also affect the head or voice. At INPM, movement disorders neurologist Dr. Alexandra Nicholson diagnoses tremor, rules out other causes and builds a treatment plan.

What are the symptoms of essential tremor?

  • Shaking of both hands and arms during action, such as writing, eating, drinking or buttoning a shirt
  • Sometimes shaking of the head ("yes-yes" or "no-no"), the voice or the legs
  • No other neurological signs, such as the slowness and stiffness seen in Parkinson’s disease

The tremor can start at any age but most often first appears in adolescence or between ages 40 and 50. It can stay mild or slowly get worse.

When should you see a doctor?

See a clinician if a tremor makes everyday tasks such as writing, typing, eating, shaving or dressing harder, or if you are not sure whether your tremor is essential tremor or something else.

How is essential tremor diagnosed at INPM?

Your neurologist reviews your history and does a neurological exam, checking muscle tone, strength, reflexes, balance and speech. A key question is whether the tremor happens at rest or during action, where it occurs in the body and whether it affects one or both sides. Laboratory tests can rule out other causes, such as thyroid problems or medicine side effects.

What treatment options are available?

Not every tremor needs treatment. When it interferes with daily life, options include medicines, avoiding things that make it worse, and, for severe tremor, procedures such as deep brain stimulation. At INPM, Dr. Nicholson assesses patients for deep brain stimulation (DBS) surgery and programs the device for patients who have one.

Who treats essential tremor at INPM?

Where can you be seen?

Walnut Woods Professional Park on Lennon Lane in Walnut Creek, where the INPM office is locatedEast Bay

INPM Walnut Creek

301 Lennon Lane, Suite 203
Walnut Creek, CA 94598

(707) 980-6636

Wed and Fri
8:00 AM – 5:00 PM
Sat
9:00 AM – 3:00 PM
Directions to the Walnut Creek office
About the Walnut Creek office
The office building at 155 Glen Cove Marina Road in Vallejo, where the INPM office is locatedNorth Bay

INPM Vallejo

155 Glen Cove Marina Rd, Suite 100
Vallejo, CA 94591

(707) 980-6636

Mon, Tue and Thu
8:00 AM – 5:00 PM
Directions to the Vallejo office
About the Vallejo office

Questions

Frequently asked questions

Call the clinic(707) 980-6636How referrals workFax (707) 980-6692 or EPIC
01

Is essential tremor the same as Parkinson’s disease?

No. Essential tremor mainly causes shaking during action, such as writing or eating, without other neurological signs. Parkinson’s tremor is often worse at rest and comes with slowness and stiffness, which is why an exam by a movement disorders specialist helps.

02

Does essential tremor get worse over time?

It varies. The tremor can stay mild or slowly get worse over the years. It most often first appears in adolescence or in middle age.

Referral required

Start with a referral from your doctor

New patients are seen by referral. Your primary care physician can fax the referral to (707) 980-6692 or send it through EPIC, and our office will call you to schedule.

How referrals workCall (707) 980-6636
  • Referral fax (707) 980-6692
  • EPIC referral
  • We call you to schedule