Mahi Dheri
Article Contents
Meaning of Essential Tremor
Doing normal, everyday tasks like holding a cup of coffee in our hands, buttoning a shirt, putting on makeup, tying shoelaces, drawing, or writing can be a daily struggle for millions of people having Essential tremor (ET).
APA Dictionary defines it as “trembling of the hands, head, or voice that appears to be hereditary. It is the most common type of movement disorder and is thought to be a benign condition, although its etiology and neurological substrates remain unclear. It is also called familial tremor.”
It can affect persons of any age, gender and race, particularly more common in old age. It is also seen that in the vast majority of all cases, it is inherited.
Causes of Essential Tremor
The true cause of the essential tremor is not known by doctors. However, theory and research suggests some of these causes:
- Overactive brain wave activity- people with ET generate overactive brain waves in the cerebellum, a brain region involved in the coordination of voluntary movement.
- Genes- Someone who has ET will have up to a 50% chance of passing down the responsible gene to their child.
Symptoms of Essential Tremor
- Tremors while moving. Tremors can occur in the face, hands and arms, head,jaw, tongue, and voice box. The most common tremor occurs in the hands, while tremors in legs and feet are least common.
- Shakiness in the hands, difficulty in doing tasks with you hands.
- Head nodding.
- Shaking sound in your voice.
- Tremors getting worse during emotional stress.
Risk factors of Essential Tremor
- Age- An essential tremor can occur within people of any age, but it is more common with those over the age of sixty-five.
- Genetic Mutation
Triggers
Certain factors may worsen the symptoms of essential tremor:
- Consumption of caffeine, nicotine , cigarettes.
- Certain medications like antidepressants, antiepileptics or inhalers may also worsen symptoms.
- Disturbed sleep cycle
- Anxiety and stress
- Engaging in fatiguing activities
Complications
Essential tremor can increase the risk for other illnesses and conditions:
- Parkinson’s disease,
- Migraine headaches
- Dementia (particularly Alzheimer’s disease)
- Depression
ESSENTIAL TREMOR V/S PARKINSON’S DISEASE- KNOW THE DIFFERENCE
Essential tremor can be confused with typical Parkinson’s disease symptoms, but the two movement disorders are separate conditions. Essential tremor is eight times more common than Parkinson’s.
Key distinguishing points include-
- Symptoms- tremor is the primary symptom in essential tremor, and tremor occurs mostly during action or movement, such as when writing, eating, or holding a posture. In Parkinson’s disease, the tremor is mostly seen at rest. Moreover, It also includes bradykinesia (slowness in the execution of movement), rigidity and gait/balance issues.
- Hereditary Causes- More than fifty percent of the patients who have ET have a family history of it, while hereditary causes of Parkinson’s disease are very rare.
- Associated body conditions- Essential tremor doesn’t cause other health problems, while Parkinson’s disease is associated with other conditions like stooped posture, slow movement and shuffling gait.
- Writing- In Essential tremor, writing tends to be large and shaky, while in Parkinson’s disease the writing tends to be slow and small, called Micrographia.
- Treatment- people with ET may get relief through medications like primidone and propranolol. On the other hand, Parkinson’s disease is generally treated through Carbidopa/Levodopa Therapy.
Treatment for Essential Tremor
Although there are no medications specifically designed to treat essential tremor, there are medicines used for other conditions that lessen tremor symptoms in some cases.
Medications:
- Beta-adrenergic blockers (beta blockers)- propranolol
- Anti-seizure medicines – primidone, gabapentin and topiramate can also sometimes be prescribed.
- Botulinum toxin (Botox) injections- For essential tremor in hands
- Blood pressure medications such as Flunarizine which limit adrenaline
Surgery:
Doctors might recommend surgery if medications don’t control tremor. It can involve deep brain stimulations and stereotactic radiosurgery.
- Deep brain Stimulation (DBS) uses mild electrical pulses to stimulate the brain and block the signals that cause tremor.
- Stereotactic radiosurgery (SRS) is a treatment that uses high-energy highly-focused radiation (X-rays) to destroy a tiny region in the brain that causes tremor to occur.
Alternative ways to treat Essential Tremor
If essential tremors are mild, these alternative ways and changes in lifestyle can prove beneficial:
- Physiotherapy- to help improve coordination and muscle control
- Following an appropriate sleep schedule
- Avoid consumption of Cigarettes, energy drinks, caffeine and nicotine, as they can worsen tremor.
- Relaxation Techniques- Rhythmic, deep and visualized breathing exercises, progressive muscle relaxation and mental imagery relaxation might prove helpful.
Essential Tremor Awareness Month
March is observed as the essential tremor (ET) awareness month. It aims to spread awareness about essential tremor, busting myths and imparting factual knowledge, reaching out to millions of people who have ET and making support accessible to all so that there is better understanding and acceptance of essential tremor among people all over the world.
This was started by the International Essential Tremor Foundation (IETF), in the USA to raise awareness of essential tremor and has since been growing internationally every year.
Helpline/ Where to get support from:
https://www.smartpatients.com/communities/essential-tremor
http://www.movementdisorders.org/
Conclusion
Essential tremor (ET) is one of the most common movement disorders in the world affecting millions of people globally. Yet, Public knowledge of the existence and features of ET is overall poor. Greater awareness and acceptance is required.
