Essential Tremor – Little Known But Common Parkinson’s Cousin
By Kelly D. Morris
Caregiver’s Home Solutions
Copyright 2014, All Rights Reserved
Gladys Barnstadt was 73 when she started experiencing tremors. At first, her hands just shook a little when she was holding a glass or a fork at mealtimes. Then her head started shaking back and forth, too. Her daughter Joann was afraid she had Parkinson’s disease and insisted she go to the doctor.
“I had seen a television show about Parkinson’s,” Joann says. “I thought that was what Mom had. Like that actor from the TV [Michael J. Fox].”
So Gladys, who lives in Hillsboro, Ohio, went to her doctor, who sent her to a neurologist. The neurologist said she did not have Parkinson’s, but she had something called essential tremor.
Gladys and her daughter Joann had never heard of essential tremor, and many people haven’t. It’s actually pretty common, however, especially among the elderly. As many as 14% of people over the age of 65 have it, although some have only mild symptoms and never even get it diagnosed.
What Is Essential Tremor?
Essential tremor, which is sometimes called familiar tremor, is simply a tremor that is not caused by another disease or disorder, like Parkinson’s disease. It usually affects the hands, but can affect other parts of the body as well, like the head and even the voice.
Symptoms of essential tremor usually begin gradually and may increase over time. Symptoms usually begin in the hands. Both hands may be affected, or it may just be one hand. The tremors usually get worse when a person is using their hands to do something, like to eat or write.
People may also have a tremor in their head. It usually makes them look like they are either nodding their head yes or shaking their head no. Their voice may also be affected.
Symptoms may get worse when people are under stress or tired.
It is believed that essential tremor may be caused by a genetic mutation in some cases. In other cases, experts say they don’t know what causes it.
How Is Essential Tremor Diagnosed?
When Joann took her mother to the doctor, she thought they would do some tests like an MRI to figure out what was wrong. But they didn’t.
Instead, the neurologist examined Gladys carefully, checking her reflexes, her coordination, and her posture. He then watched her drink from a glass (which made her hands tremble) and draw a spiral. He asked her about her symptoms and what medications she was on.
Your loved one’s doctor might also do some blood tests to check for thyroid problems. He or she might order a test like a CT scan or an MRI to rule out other problems, but those things aren’t actually used to diagnose essential tremor. In most cases, essential tremor is diagnosed based on a neurological exam.
Treating Essential Tremor
In some cases, symptoms of essential tremor are mild and no treatment is necessary. If a person’s tremors interfere with their daily life, though, there is treatment available.
There are a number of medications that can be used to treat essential tremor. Sometimes beta-blockers, medications that are often used to treat high blood pressure, can help. If beta-blockers are not effective, sometimes anti-seizure drugs are prescribed. Make sure your loved one’s doctor knows about any other medications they are taking and if they have any other medical problems, like asthma, diabetes, or heart trouble, because that might affect what medications can be given to them for essential tremor.
Sometimes Botox injections are used to treat tremors. This is the same type of injection you might be familiar with that is used to treat facial wrinkles. Doctors will usually try medications before they try Botox, though.
Your loved one’s doctor might recommend physical therapy. Physical therapy exercises can reduce tremors and improve coordination and muscle control.
An appointment with an occupational therapist might be helpful, as well. An occupational therapist can evaluate how your loved one performs certain tasks and recommend techniques or appliances that can help. For instance, the therapist might suggest using heavier plates, glasses, or utensils to make eating easier.
If medication and therapy don’t help, and if tremors are seriously disabling, sometimes surgery is recommended. The most common surgical procedure for essential tremor involves inserting an electrical probe into the part of the brain responsible for causing the tremors. A wire runs under the skin from the probe to the chest, where a pacemaker-like device is inserted. The device sends electrical pulses (they are painless) to interrupt the signals from the brain that are causing the tremors.
In Gladys’ case, her doctor prescribed a beta-blocker called Inderal, which helped a lot.
Other Things That Help
You should keep in mind that certain things can make tremors worse, including caffeine (found in soft drinks, coffee, tea, and chocolate), stress, and fatigue. Limiting the amount of caffeine in a diet can help a lot. So can getting enough rest. If your loved one is under a lot of stress, you can help them practice relaxation techniques. In some cases, counseling helps people learn to deal with stress.
Some people find that when they drink alcohol, it actually reduces tremors temporarily. However, once the effects of alcohol wear off, the tremors usually come back worse than before. And, of course, drinking alcohol can contribute to other health problems. So, people with essential tremor are advised not to drink a lot, if they drink at all.
Keep in mind that it can be very frustrating to have a condition like essential tremor. People with the condition may be embarrassed about how their hands shake, especially if it causes them to spill food while they’re eating or something like that. Be patient and supportive of your loved one while he or she is dealing with this problem. Some people with essential tremor find it helpful to attend a support with other people dealing with the condition.
For More Information
For more information on essential tremor, you can contact the International Essential Tremor Foundation at PO Box 14005, Lenexa, KS 66285. You can also phone them at 913-341-3008 or visit their website at www.essentialtremor.org.
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Kelly Morris is a former social worker and home health and hospice worker whose writing has appeared in a number of health-related journals. She lives in Mansfield, Ohio.
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