Summary about Disease
Essential tremor (ET) is a neurological disorder that causes involuntary, rhythmic shaking. It most commonly affects the hands, but can also affect the head, voice, legs, or trunk. It is not life-threatening, but it can significantly impact a person's daily activities and quality of life. ET is often confused with Parkinson's disease, but they are distinct conditions.
Symptoms
The primary symptom is involuntary shaking (tremor). Other symptoms may include:
Tremor that worsens with movement
Tremor that lessens with rest
Tremor that is more noticeable during times of stress or fatigue
Head nodding (yes-yes or no-no)
Voice tremor
Balance problems (less common)
Difficulty with fine motor skills (e.g., writing, using utensils)
Causes
The exact cause of essential tremor is unknown. It is believed to involve abnormal electrical activity in the brain, specifically in the cerebellum and other areas that control movement. Genetics play a role, as ET often runs in families. It is considered that in at least half of cases, genetics play a role and can be passed on by a parent.
Medicine Used
Medications do not cure essential tremor, but they can help manage symptoms. Common medications include:
Beta-blockers: Such as propranolol. They block the effects of epinephrine (adrenaline) and help reduce tremor.
Anti-seizure medications: Such as primidone. They help calm overactive nerve cells.
Tranquilizers: Such as alprazolam or clonazepam. Are typically used as a last resort as they have a tendency to be addictive.
OnabotulinumtoxinA (Botox) injections: Used to treat tremors in the hands and head.
Deep brain stimulation (DBS): Surgical option for severe cases.
Is Communicable
Essential tremor is not communicable. It is not contagious and cannot be spread from person to person.
Precautions
While there is no way to prevent essential tremor, lifestyle modifications can help manage symptoms:
Avoid triggers: Identify and avoid substances or situations that worsen your tremor, such as caffeine, stress, and fatigue.
Use assistive devices: Utensils, writing aids, and other tools can make daily tasks easier.
Physical therapy: Improve strength, coordination, and balance.
Stress management: Practice relaxation techniques, such as deep breathing, meditation, or yoga.
Support groups: Connecting with others who have ET can provide emotional support and practical advice.
How long does an outbreak last?
Essential tremor is a chronic condition, meaning it is long-lasting and usually does not go away. It is not an "outbreak" that resolves after a period. The tremors may fluctuate in intensity, but the condition is persistent.
How is it diagnosed?
Diagnosis typically involves:
Physical and neurological examination: To assess tremor characteristics, reflexes, muscle strength, and coordination.
Medical history: Including family history of tremor.
Ruling out other conditions: Blood tests and imaging studies (such as MRI) may be used to exclude other causes of tremor, such as Parkinson's disease, thyroid problems, or medication side effects.
Tremor analysis: Observing the tremor's characteristics (e.g., when it occurs, which body parts are affected).
Timeline of Symptoms
The onset of essential tremor can occur at any age, but it is most common after age 40. The progression of symptoms varies from person to person.
Early stages: Mild tremor, often intermittent.
Progression: Tremor becomes more frequent, persistent, and severe. It may spread to other body parts.
Advanced stages: Tremor significantly interferes with daily activities. Balance problems and other neurological symptoms may develop. The timeline is highly variable. Some people experience slow progression over decades, while others experience more rapid symptom worsening.
Important Considerations
Differentiation from Parkinson's disease: ET and Parkinson's disease both cause tremor, but they have distinct features. ET tremor typically occurs with movement (action tremor), while Parkinson's tremor often occurs at rest (resting tremor). Other symptoms, such as rigidity and slowness of movement, are more characteristic of Parkinson's disease.
Impact on quality of life: ET can significantly affect a person's ability to perform daily tasks, such as eating, writing, and dressing. It can also lead to social isolation and anxiety.
Treatment options: While there is no cure for ET, various treatments are available to manage symptoms and improve quality of life.
Genetic counseling: If ET runs in your family, genetic counseling may be helpful.
Regular follow-up: It is important to see a neurologist regularly to monitor your symptoms and adjust treatment as needed.