What Is Essential Tremor (ET)?
Essential tremor is a neurological condition that presents with tremors, most commonly in the hands and arms. A tremor is a rhythmic, uncontrollable movement of a physical body part, and it is characterized by uncontrollable shaking or trembling of the affected area.
Essential tremor is frequently confused with Parkinson's disease, but the two diseases are distinct in several respects. An essential tremor is an action tremor, which means that when you do some movement and try to use your hands, the uncontrollable shaking gets worse. Tremors are most noticeable at rest in Parkinson's disease, and an activity alleviates the symptoms. Only a few patients with Parkinson's disease suffer head shaking or nodding, whereas it is commonly seen as a result of essential tremors. Balance issues, arm and leg rigidity are common symptoms of Parkinson's disease but not essential tremors.
What Are the Symptoms of Essential Tremor?
Essential tremor is a condition associated with a wide range of symptoms. The age of onset, progression, tremor distribution, and intensity of tremor can all differ significantly from one person to the next.
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Tremor is a common symptom of essential tremor, and it manifests itself as uncontrollable shaking or trembling of the hands or arms. Tremors of the hands or arms might occur on their own in some circumstances. Both hands or arms are usually afflicted, albeit one side of the body is usually more affected than the other. Tremor is most commonly caused by people attempting to produce voluntary motions (kinetic tremor). Simple actions such as pouring a drink, drinking from a cup, using utensils, tying shoelaces, drawing, or writing are examples of such movements. Tremors can affect the head (including the neck), voice, jaw, and tongue.
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Some people who are affected also have a problem coordinating voluntary movements (ataxia), which affects the muscles in their legs. This can result in an awkward or uncoordinated walking style (abnormal gait).
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Hearing loss and mild olfactory dysfunction have also been described. Non-motor symptoms manifest themselves more frequently in essential tremor patients than in general. Cognitive deficiencies, personality changes, and sadness are examples of such symptoms. Individuals at an older age of onset of the condition appear to be more likely to develop cognitive impairment.
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Individuals with essential tremors are also prone to postural tremors. A postural tremor happens when a person tries to keep a steady position against gravity, such as when holding a cup with arms outstretched in front of their body.
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Essential tremor is frequently linked to a wide range of social and psychological repercussions. The disease can make it challenging to carry out daily tasks and can significantly impact a person's quality of life. Because of their anxiety and irritation, people who are affected may avoid social or unpleasant settings. Certain medications, caffeine, and stress can exacerbate your tremors.
What Are the Causes of Essential Tremor?
Essential tremor has no recognized etiology. According to one proposition, the cerebellum and other regions of the brain might not be functioning and coordinating correctly, and as the cerebellum is in charge of motor coordination, it can cause tremors.
The disease appears to be handed down from parent to child in the majority of cases as an autosomal dominant feature. It is a condition where just one copy of a defective gene is required for the disease to manifest; however, different routes of inheritance are increasingly being investigated. The impaired gene can be inherited from either parent or be caused by a new mutation in the affected person. Regardless of the sex of the resulting child, the risk of transferring the faulty gene from the affected parent to children is fifty percent for each pregnancy. If one set of parents has an essential tremor condition, there is a fifty percent risk that the offspring may inherit the gene that causes the disease.
How Is Essential Tremor Diagnosed?
A diagnosis of essential tremor is made based on the presence of specific symptoms, a complete patient history, and a thorough clinical examination. Essential tremor cannot be diagnosed using a specific test, and to rule out other possible causes of tremor, a neurological exam and additional testing may be performed.
The patient should consult a skilled neurologist if they are experiencing symptoms of essential tremor. The doctor will ask questions about the patient’s health, their family's medical history, any medications they are taking, and any procedures they have had during the evaluation. The evaluation will also be useful in determining whether any circumstances aggravate or ease the tremor. The doctor will conduct a comprehensive examination, noting the parts of the body that are affected by tremor, when it occurs, and whether any other symptoms could indicate a movement problem other than ET. Imaging studies like magnetic resonance imaging (MRI) and computerized tomography (CT) scans do not help to identify essential tremors, but they can help phase-out other possibilities.
How Is Essential Tremor Treated?
Essential tremor has no cure, but the symptoms can be controlled in a variety of ways, beginning with the practical steps like:
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Practicing relaxation techniques like yoga, deep breathing exercises, or biofeedback.
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Caffeine and alcohol should be avoided.
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Trying to stay away from stressful circumstances.
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Consult the doctor to see if any of the medications you're taking are causing your tremors to get worse.
Medication and surgical intervention are two of the most common therapies for essential tremors.
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Medications- Tremors are best treated with Propranolol and Primidone. Excessive blood pressure and anxiety during sports are treated using the beta-blocker, Propranolol. Slow heartbeat, tiredness, and shortness of breath are some of the mild to moderate adverse effects. Propranolol should not be used by anyone who has asthma. Drowsiness, difficulty concentrating, nausea, and dizziness are some of the mild-to-moderate side effects of Primidone, an anti-seizure medicine. Both of these medications can lessen tremors by up to half.
A few more medications may aid with essential tremor treatment, but the evidence is not as solid. The beta-blockers, Atenolol and Sotalol, as well as the anti-seizure medications, Gabapentin and Topiramate, are among them.
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Surgery- If medicine fails to alleviate essential tremors, surgery may be an option. Surgery is always dangerous, but it is extremely dangerous when it involves the brain. Thalamotomy and deep brain stimulation are the two most well-studied surgical treatments for severe limb tremor that has not responded to medicines. Both methods can help with limb tremors, but not with head shaking or a quavering voice.
Conclusion:
Even though essential tremor is not a life-threatening condition, it can be quite unpleasant for those who suffer from it. Some essential tremor patients may feel compelled to isolate themselves from family and friends, but avoiding social situations is not advised. In addition to doctor-prescribed therapies, practical tips help persons with essential tremors continue active social lives. Maintaining mental and physical well-being requires remaining socially active.
