6.ESSENTIAL TREMORS

Collected,Compiled, Edited and Presented by:-

DR.V.JAGANNATHAN

Essential tremor is a movement disorder that causes involuntary, rhythmic shaking  movements especially in the hands. 

Essential tremors (ET) was defined as mono-symptomatic tremor syndrome involving both upper limbs during action for at least 3 years, with or without tremor in other body parts

 It is distinguished from tremor of other disorders or known causes, such as Parkinson's disease or head injury.                                                                           

Essential tremor usually occurs alone, without other neurological signs or symptoms. However, some experts think that essential tremor can include additional features, such as unsteadiness of gait.

Essential tremor usually occurs with movements and can occur during many different types of activities, such as eating, drinking, or writing.                                          

 Essential tremor can also occur when the muscles are opposing gravity, such as when the hands are streched. It is usually not evident at rest.

In addition to the hands and arms, muscles of the trunk, face, head, and neck may also exhibit tremor in this disorder; the legs and feet are less often involved.                                                                                                                                  

 Head tremor may appear as an up and down movement  or a side ways lateral  movement while the affected individual is seated at rest.                                                        

 In some people with essential tremor, the tremor may affect the voice .

Essential tremor are not lifethreatening. However, it may interfere with fine motor functions like using eating utensils, writing, shaving, or applying makeup, and in some cases these and other activities of daily living can be greatly impaired.                                                                                                                          Symptoms of essential tremor may be aggravated by emotional stress, anxiety, fatigue, hunger, caffeine, cigarette smoking, or temperature extremes.

Essential tremor is most common in older adults. Some studies have suggested that people with essential tremor have a higher than average risk of developing neurological conditions including Parkinson's disease or sensory problems such as hearing loss, especially in individuals whose tremor appears after age 65.

Frequency

Essential tremor is a common disorder. Estimates of its prevalence vary widely because several other disorders, as well as other factors such as certain medications, can result in similar tremors., Mild cases are often not brought to medical attention, or may not be detected in clinical exams. Severe cases are often misdiagnosed as Parkinson's disease.

Causes

The causes of essential tremor are unknown. Researchers are studying several areas  on particular chromosomes that may be linked to essential tremor, but no specific genetic associations have been confirmed.. The specific changes in the nervous system that account for the signs and symptoms of essential tremor are unknown.

Inheritance

Essential tremor can be passed through generations in families, but the inheritance pattern varies. In most affected families, essential tremor appears to be inherited in an autosomal dominant pattern,  although no genes that cause essential tremor have been identified.                                                               

 In other families, the inheritance pattern is unclear.                                                                 

Essential tremor may also appear in people with no history of the disorder in their family.

In some families, some individuals have essential tremor while others have other movement disorders, such as involuntary muscle tensing (dystonia).                        

The potential genetic connection between essential tremor and other movement disorders is an active area of research.

Other Names for This Condition

• Benign essential tremor
• Familial tremor
• Hereditary essential tremor

Treatment oftions

There’s no cure for essential tremor, but it can be controlled. The main treatment options are medications, assisting devices, botulinum toxin, deep brain stimulation and focused ultrasound.

Medication: The most common medications, taken either on their own or in combination, to treat essential tremor are beta-blockers like propranolol and anti-seizure drugs like primidone.

• Adaptive devices: Many devices have been developed to improve tremor control, such as weighted items, tremor-canceling devices, vibration devices and peripheral nerve stimulation.
• Botulinum toxin: This involves injection into the tremoring muscles to temporarily weaken the muscles and lessen tremor severity.
• Deep brain stimulation: This is a surgery to implant a device that delivers electrical impulses to a specific part of your brain. The electrical impulses interrupt the signals that cause essential tremor muscle movements.
• Focused ultrasound: This procedure uses ultra-high-frequency sound waves focused onto a single point in the brain involved in the production of tremor, destroying the targeted tissue. This destruction can greatly reduce the severity of the tremor and improve hand steadiness..

Prognosis

Essential tremor is usually progressive. This is usually a slow process. The average rate that arm or hand tremors get worse is between 1.5% and 5% a year.

Essential tremor starts small and usually only affects the hands at first. Over time, usually many years, the tremors may spread to affect the arm and head. As the condition progresses, you may begin to struggle with certain activities and may need help to do them.

Essential tremor is a permanent, life-long condition once it starts. It’s not curable, and it doesn’t go away on its own.

Collected,Compiled, Edited and Presented by:-

DR.V.JAGANNATHAN

October 12^th 2024