Most of us don’t know what is essential tremor disorder, even though it is a growing health problem around the world. Here, you’ll get to know the main facts about this brain disorder.
Essential tremor is a neurological condition that causes involuntary and rhythmic shaking of hands. Other parts (like head, tongue, and jaw) can also be affected but the trembling of hands is more common. The tremor is prominent when the hands are in actions, like drinking a glass of water or eating from a plate.
Since tremor is the key symptom of essential tremor and its diagnosis is based on the presence of tremor, hence it’s called essential tremor. This term was first used in 1874 by an Italian professor named Pietro Burresi.
Essential tremor is not a dangerous condition, but it typically worsens over time and can be severe in some people. Although the tremor can occur at any age, it is most common in people age 40 and older.
Essential tremor is a growing health concern worldwide. Currently, there are approximately 41 million people around the world who are suffering from this condition. In the USA alone, there are more than 7 million cases that correspond to 2.2% of the USA population.
What Causes it?
The exact cause of the essential tremor is still unknown. Researchers think that genetics play a key role in its onset. Almost half of the affected cases are linked to an abnormality in genes. To date, more than 11 defective genes have been identified that are strongly linked to essential tremor.
Besides genetics, numerous environmental toxins that are known to cause or increase the risk of developing essential tremor. These include pesticides, mercury, lead, and harmane.
Increasing age is also considered to be a risk factor for developing essential tremor. The chances of developing the disease increase as a person gets older.
What are its Symptoms?
Tremor is the primary symptom of essential tremor. It usually appears on one hand and then gradually affects the other hand. Besides hands, the tremor can also affect body parts like the head, tongue, and jaw. Its intensity increases over time and also in a situation when a patient is exposed to emotional stress or consumed more caffeine than normal.
In addition to tremor, impaired gait is another important motor symptom of essential tremor. This sign of the disease was undermined for many years but now considered as one of the key symptoms of essential tremor. In this case, a patient usually shows an abnormality in the tandem gate with an increased number of missteps.
A patient may also experience some non-motor symptoms during the course of the disease. These include sleep disturbances, loss of smell, depression, and personality changes. However, these problems are less intensive and rarely reported.
What are the Complications Associated with it?
Essential tremor is not a deadly disease. However, its symptoms often worsen over time and this can make it difficult to perform routine tasks. For example, the affected person often finds it difficult to drink from a glass, eat with normal utensils, brush the teeth, and put on makeup or shave. This is why people with essential tremor are often advised to use assistive products that can make it easy for them to perform these simple tasks.
How to Diagnose it?
Unfortunately, there is no specific medical test available for the diagnosis of essential tremor. To perform a correct diagnosis, the doctor needs to review your medical history, family history, your most recent symptoms, and conduct a physical examination.
In a neurological examination, a doctor tests your nervous system functioning, including checking tendon reflexes, muscle strength, and tone, ability to feel certain sensations, posture, and coordination.
Very often, the blood and urine are also tested for several factors or to rule out other medical conditions that include metabolic problems, drug side effects, and thyroid disease.
A doctor may ask for the following activities to be performed to check whether the tremor is essential tremor or Parkinson’s tremor.
- Drink from a glass
- Hold your arms outstretched
- Write a name on the paper
- Draw a spiral
What are the Available Treatment Options?
It usually does not require treatment if the tremor is mild. But if the tremor is making it difficult to work or perform daily activities, your doctor should prescribe medication, which is the most effective way of dealing with essential tremor.
The drugs Primidone and propranolol are commonly used to treat essential tremor. Primidone is a beta-blocker that is used as first-line therapy. Propranolol is an anti-epileptic drug and is prescribed when a patient is not responding to primidone. When both drugs failed to improve the tremor, a drug called botox is used in the form of injection. Side effects associated with the use of these drugs include fatigue, nausea, and lightheadedness. In some patients, they may also cause heart problems.
A surgical procedure called deep brain stimulation is used when medications are no longer effective in controlling the tremor. This approach is considered to be very effective and become a routine treatment for people with tremors.
Physical therapy can also be helpful. It involves exercises that help to improve muscle strength, control, and coordination. Moreover, some patients may need occupational therapy which helps them to adapt to living with this condition.