Essential Tremor
Overview
Essential tremor is a neurological condition that causes the hands, head, trunk, voice, or legs to shake involuntarily and rhythmically. It can affect any part of the body, but the trembling occurs most often in the hands, especially when doing simple tasks, such as drinking from a glass.
Essential tremors can also affect the head, voice, face, and rarely the legs. This movement disorder is not life-threatening. It is often confused with Parkinson's disease.
Essential tremor is the most common trembling disorder. Everyone has at least a small degree of tremor, but the movements usually cannot be seen or felt because the tremor is so small. When this condition is noticeable, it is classified as an ‘Essential tremor.
Symptoms
If one has essential tremors, they will experience shaking and trembling. Certain characteristics are common to all. Individuals may experience-
• Tremors occur when an individual moves, but are less noticeable when at rest.
• Certain medicines and stress can make the tremors worse.
• At times essential Tremors may improve with the ingestion of a small amount of alcohol (such as wine).
• Tremors get worse as one grows older.
• Tremors affect both sides of the body differently.
• Signs of essential tremor:
-Tremors that are most obvious in your hands
-Difficulty doing tasks with your hands, such as writing or using tools
-Shaking or quivering sound in your voice
-uncontrollable nodding of the head.
Causes & Risks
• The actual cause of essential tremor is unknown but it is often passed down from a parent to a child.
• One theory suggests that the cerebellum and other parts of the brain are not communicating as they should be.
• A disruption in communication between different parts of the brain, especially within networks involving the cerebellum, that controls and coordinates muscle movement, results in abnormal movements.
• Essential tremors can occur in families that can be passed on.
• Essential tremor is usually not a dangerous condition, but it typically worsens over time and can be severe in some people.
• High amounts of Caffeine intake or cigarette smoking can cause essential tremors.
Test & Diagnosis
• A tremor, in the setting of a comprehensive neurological examination, can result in the diagnosis of essential tremor.
• The doctor will need to rule out other conditions that could cause shaking or trembling. For example, tremors could be symptoms of diseases such as hyperthyroidism. The healthcare provider may test for the same.
• In some cases, the tremors can be related to other factors. To ensure this, the healthcare provider may advise one to - Refrain from heavy alcohol use.
• Trembling is a common symptom among people with alcohol use disorder, avoid caffeine and reduce certain medications.
Treatment
Treatment consists of supportive therapy to manage symptoms and improve the quality of life
• Treatment includes medication, such as beta-blockers. This beta blocker is effective in 50% of patients and is less useful in reducing head and voice tremors.
• Beta blockers are avoided in patients with asthma, emphysema, congestive heart failure, or heart block, and should be used with caution by people with diabetes and who are on insulin. These drugs may reduce exercise tolerance, lower blood pressure or heart rate, exacerbate depression, and cause impotence.
• Supportive care- Monitoring for any changes or improvement
• Focused ultrasound therapy – a therapy with the potential to improve the quality of life and decrease the cost of care for patients.
Living With
Living with essential tremor is challenging – affecting the hands, but it can affect other parts of the body too. Essential tremor is often a progressive condition that can vary in severity and impact an individual's daily lifestyle.
Below are the features of essential tremors…
The greatest challenge of essential tremors is uncontrollable shaking, which can make simple tasks very difficult to perform. These tremors can worsen with movement or stress and can vary in intensity.
Handling embarrassing symptoms of essential tremors can lead to emotional challenges. Individuals may experience frustration, embarrassment, or self-consciousness, especially in social circles.
Individuals with this disorder often find ways to adapt to their condition by using assistive devices.
Managing essential tremors can include medications like beta blockers or anti-seizure medications. In some cases, deep brain stimulation (DBS) or other surgical procedures may be considered for severe, debilitating tremors.
Complications
• Essential tremors, while primarily characterized by involuntary shaking or tremors, can lead to several complications that impact an individual's daily life.
• The tremors associated with essential tremors can make everyday tasks challenging. Activities requiring fine motor skills, such as writing, drinking, eating, or buttoning clothes, may become more difficult or nearly impossible due to the shaking.
• Essential tremors can interfere with an individual's ability to perform certain jobs or tasks that demand precision or fine motor skills.
• Living with essential tremors can lead to emotional challenges, including feelings of embarrassment, self-consciousness, or depression due to the impact of tremors on social interactions and self-esteem.
• Severe tremors may increase the risk of injury, especially while handling sharp objects or cooking.
