Although there is no cure to essential tremor, there are medications which will help to control the symptoms. These include anti-epileptics, beta blockers, benzodiazepines or a combination of beta blocker and anti epileptic.

For most individuals, Beta-adrenergic-blocking drugs such as Propranolol and Primidone are the mainstays of therapy. Patients with asthma or congestive heart disease cannot use Propranolol. Improper use of the drug can cause intolerable side effects. When Primidone is first used, up to 25% of patients have an initial reaction but side effects are less common after the first week of therapy. These drugs, which can be taken together, will often suppress the tremor and improve functional disability.

Other treatments include:

• Alcohol (yes really!) - It has been shown that small amounts of alcohol may suppress the symptoms in some patients.

• Botulinum Toxin injections into tremulous muscles at the nerve muscle junction producing a reduction in muscle activity and thereby a reduction in tremor amplitude. It is particularly useful for some head tremors.

• Surgical Techniques - These are now alternatives to be considered when conventional drug treatment has proved ineffective. These include:

  Stereotactic Thalamotomy (surgery of the brain in which a lesion (scar) is made in the thalamus to block the electric impulses that cause tremor).

  Deep Brain Stimulation in which an electric stimulator is implanted into the thalamus and produces small electric impulses which instead of permanently damaging the brain via thalamotomy, can block the tremorgenic centre in the brain.

  Gamma Knife Therapy which allows a small "burn" to made (much the same as the thalamotomy) without a hole or operation being necessary. Obviously there are risks attached to all of these surgical techniques and these should be discussed fully with a patient before proceeding.