Have you ever felt like your hands were shaking a little while holding a cup of tea, signing a document, or just sitting still? You might think that this is something that happens when you're tired or a little scared. But if it persists, it could be due to a condition called ' Essential Tremor '. Don't be scared when you hear this name. Let's talk about it all simply and clearly.
What is Essential Tremor?
Simply put, Essential Tremor is a movement disorder that affects our nervous system. It causes parts of our body to shake in a rhythmic manner that we cannot control. It often starts in the hands . This tremor is more noticeable when you use your hands to do something.
This is a progressive condition. This means that over the years, the tremors may not only be limited to the hands, but may also spread to the head, voice box (larynx), jaw, face, trunk, and sometimes legs. But this often happens very slowly , and you may not need any treatment for many years.
The important thing is that this condition is not life-threatening. And it does not shorten your lifespan. However, for some people, it can make it difficult to perform everyday tasks , such as eating, dressing, and writing.
What causes Essential Tremor?
Doctors are not yet sure what exactly causes this, but they believe it is a neurological condition that begins in the nervous system, that is, the brain, spinal cord, or nerves.
It is currently known that about 50% of people with Essential Tremor also have another family member with the condition. This means that there is some hereditary link to it. However, it has not yet been found that it is caused by a single gene. It is possible that it is caused by a combination of hereditary and environmental factors.
Simply put, there is a part of our brain called the 'Cerebellum' . This is what coordinates and finely controls our muscle movements. In the case of Essential Tremor, it is thought that there is a change in the communication links between this cerebellum and other parts of the brain.
Other causes of tremors
Although essential tremor is the most common cause of tremor, there are other causes of this type of tremor, which is why it's important to see your doctor to find the exact cause.
| Other factors affecting tremors |
|---|
| Other neurological diseases such as Parkinson's disease, multiple sclerosis, or stroke. |
| Overactive thyroid. |
| Impaired liver or kidney function. |
| Severe stress, anxiety, or fatigue. |
| Excessive consumption of beverages containing caffeine (tea, coffee). |
| Some medications for asthma and mental illness. |
| Exposure to toxins such as heavy metals like mercury and lead and pesticides. |
What are the main symptoms of Essential Tremor?
There are several main symptoms you may experience in this condition, but not everyone will experience all of these symptoms.
| Symptom | Description |
|---|---|
| Tremor in the hands | This is the most common and obvious symptom. |
| Voice tremor | Feeling a trembling in the voice when speaking. |
| Head shaking | Uncontrollable shaking of the head as if saying 'yes' or 'no'. |
| Increase with movement | Tremors are more noticeable when you are making movements, such as holding something or writing, than when you are at rest. |
| Increase in some things | Stress, overexertion, caffeine, and some medications can temporarily increase tremors. |
| Reduction in alcohol | Surprisingly, some people find that drinking a small amount of alcohol temporarily reduces their tremors (but this is not recommended as a treatment). |
How does a doctor diagnose this exactly?
If you have these symptoms, the best thing to do is see a doctor . The doctor will ask you about your medical history, whether anyone in your family has had them, and then perform a physical examination.
A neurological exam, specifically related to the nervous system, can look for the following:
- The strength and condition of your muscles.
- Reflexes .
- Body balance.
- How do you feel when you move and when you are at rest?
- The speed and amount of shaking.
Additionally, blood tests and urine tests may be done to rule out other conditions that could be causing the tremors. Sometimes, a brain scan may also be recommended.
What are the treatments for Essential Tremor?
First of all, if your tremor doesn't significantly interfere with your daily activities, you may not need any treatment. However, if it's affecting your quality of life, there are several treatments that can help.
Medication
There are several types of medications that can help control tremors. You may need to try a few different types to find the one that works best for you. The most important thing is that all of these medications should only be used under the supervision of a doctor.
| Treatment level | Types of drugs (examples) |
|---|---|
| First-line therapies - the most commonly used | |
| 1 | Propranolol (Hemangeol, Inderal) |
| 2 | Primidone (Mysoline) |
| Second-line therapies | |
| - | Medications such as Alprazolam (Xanax), Atenolol, Gabapentin (Neurontin), Topiramate (Topamax). |
Other treatments
- Adaptive devices: Some people can control tremors by using things like wrist weights and heavier cutlery.
- Botulinum toxin injection: This injection may be helpful for people who have tremors in the head or voice.
- Deep Brain Stimulation (DBS): This is a surgical procedure. In this procedure, a very thin electrode is inserted into the part of the brain called the thalamus that causes tremors, and it is connected to a small device (like a pacemaker) that is placed under the skin of the chest. This device can control the abnormal electrical messages going to the brain, reducing tremors by about 70%-90%.
- MRI-guided focused ultrasound: This is a new technique. Without surgery, high-intensity ultrasound beams are directed with the help of an MRI machine to destroy the relevant cells in the thalamus of the brain.
Take-Home Message
- Essential tremor is a common, but not life-threatening, nervous system condition.
- The main symptom of this is tremors in the hands, head, or voice that increase while working.
- There may be a hereditary link to this, but you can still develop it even if no one in your family has it.
- If your tremors are making it difficult to perform daily tasks, don't panic and see a doctor . There are many effective treatments to control this.
- Never self-diagnose or take medication without the advice of a doctor.
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