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ESSENTIAL TREMORS

 

Essential tremor is a neurological disorder that occurs due to abnormal electrical activity of the brain that causes involuntary movements of the body. These involuntary movements are only observed in the upper part of the body. However, the major movements of these tremors are seen in the hands.

Essential tremors are not life-threatening but may cause mild to moderate trembling in the upper body parts. These affect the normal functioning of the individual and are observed in:

  • Hand
  • Head
  • Neck
  • Tongue
  • Jaw
  • Larynx (Voice box)
  • Torso

Essential tremor is not a major neurological condition. Therefore, treatment is provided for the symptoms to minimize the risk of neuronal damage or disability.

Sign and Symptoms

The signs and symptoms of essential tremor include:

  • Trembling of the upper part of the body
  • Usuallybegins on one hand, affects one or both the hands
  • Does not affect the lower ipsilateral extremities
  • Intensifies with movements
  • Increased head movements
  • Shakiness in the voice
  • Difficulty in maintaining balance
  • Increased intensity of tremors during emotional stress, fatigue or hunger

Diagnosis

The initial diagnosis of essential tremor is usually based on the physical findings and the family history of the individual. There is no specific biological marker to detect essential tremors. However, the doctor recommends a set of laboratory tests and image scans that helps in detecting the condition.

The laboratory tests for essential tremors include blood and urine test to determine any abnormality of the thyroid functions, electrolyte imbalance and alcohol intoxication. The test also helps to determine the occurrence of adverse side effects of any drug.

The image scans such as computed tomography (CT) scan and magnetic resonance imaging (MRI) scan helps in determining the underlying cause of tremors such as Parkinson's disease, multiple sclerosis, migraine headache or muscle weakness. Image scan is performed when the intensity of the tremors are acute and intensifies over a period.

Apart from laboratory and imaging scan, a set of performance test is performed that helps in analyzing the severity of the condition. The individual may be analyzed for:

  • The ability to hold an object in the hand
  • The ability to stretch out the hand without shakiness
  • The ability to write without trembling
  • The ability to draw spirally on a paper
  • The ability the hold the face steadily without shaking.

Causes and Risk Factors

Essential tremors are assumed to occur due to abnormal brain impulses or due to gene mutations. However, the exact cause of essential tremor is not known in people with genetic mutations. A child of the diseased parent with essential tremors is at a higher risk of developing the condition.

The incidences of essential tremor are known to increase in people above 40 years of age.

Complications

Essential tremors are known to affect your daily activities such as:

  • Difficulty in holding  a cup or a glass of water
  • Difficulty in writing
  • Increased shakiness while eating
  • Difficulty in running a razor blade over the face
  • Increased shakiness while shaking hands
  • Difficulty in eating normally

Treatment

Depending on the severity of the condition, essential tremors can be treated either through use of medicines or surgical procedures.

Medication therapy:

The doctor may prescribe either anti-epileptic agents, beta blockers, tranquillisers or botox injections.

Anti-epileptic drugs: It prevents the excitability of the nerve cells that help in reducing nerve activity.

Beta blockers: It prevents the worsening of essential tremors by limiting the release of adrenaline.

Tranquillizers: It helps in calming down the patients as anxiety and tension increase the risk of tremors.

Botox injections:It is used to treat certain types of tremors such as head tremors. However, if these injections are used for hand tremors, they cause weakness of the fingers.

Surgery

Surgery is a suitable option for treatment of essential tremors when the individual does not respond to medication therapy. The surgery may involve deep brain stimulation, where a probe is inserted into the thalamic region of the brain. The wire of the probe is connected to a neuro-stimulator device that is attached to the chest.

This device helps in the transmission of signals to the brain preventing the brain from releasing signals that cause tremors.

Other Physical Therapies

The doctor may suggest physiotherapy, physical exercise and yoga toimprove muscle strength and tensile strength that helps in relieving the symptoms of essential tremors. However, these therapies are suggested along with medication or surgery for better recovery from the condition.

Coping/Self-Management

There is no cure for essential tremors. The regular use of medicines with regular exercise helps in easing the symptoms of essential tremors. It is advised to follow-up with the doctor if the symptoms of the tremors worsen over time.

 

 

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