Essential Tremor Treatment in Mumbai, India

Essential tremor is a neurological or nervous system disorder that causes involuntary and rhythmic shaking. It can affect almost any part of the body but shaking or trembling most often occurs in the hands. It also affects other body parts like legs, voice, head, etc. It affects simple tasks like writing, tying shoelaces, drinking, etc.

Associated Anatomy

Nervous system

Alternate Name

It is also known as the familial tremor.

Symptoms of Essential Tremor

A few signs and symptoms of essential tremor are:

• Noticeable trembling or shakiness of a hand or a leg
• Shaking of head up and down or side to side
• Sudden eye twitches
• Balancing and problems with walking due to tremors in the legs and core
• Difficulty speaking and lack of clarity while speaking due to tremors in the tongue or voice box

Causes of Essential Tremor

The exact reason behind essential tremors is unknown. Some of them can be

• Genetic mutation. It is also known as familial tremor. It is one of the most common causes of essential tremors
• Thyroid gland overactiveness. It can cause an imbalance of thyroid hormones.
• Excess alcohol intake or alcohol addiction
• Stroke can also cause these tremors sometimes
• Certain neurological conditions.

Typical Test To Detect Essential Tremor

The doctors make the diagnosis of essential tremors by ruling out other conditions. A physical examination is performed to check for reflexes, posture, muscle strength, tone, etc. Other tests or exams like CT or MRI are not necessary to rule out any underlying cause such as a tumor. It is essential to inform your family history and symptoms to the doctor.

Possible Essential Tremor Treatment

Treatment is unnecessary for everyone with essential tremors, especially if the symptoms are minor. However, some possible Essential Tremor treatments can lower the symptoms.

• Medications - Beta-blockers (relieves tremors), anti-seizure medications (when beta-blockers are not enough), and tranquilisers (to reduce anxiety which can worsen tremors).
• Therapies - Botox injections into the muscles can lower the tremors. Physical therapy can strengthen the muscles and improve coordination.
• Surgery - When the symptoms are severe and debilitating. There are two surgeries: Deep brain stimulation (transmits painless electric pulses to the parts of the brain that reduces causes tremors) and Focused ultrasound thalamotomy (which uses sound waves to damage the parts of the brain that causes tremors)

Risk Factor OF Essential Tremor

A few of the most common risk factors for essential tremors are

• Age - People over the age of 40 are more at risk. It is less common among the younger population
• Family history - Genetics can play a role. But it also happens in people without a family history of essential tremors
• Emotional stress increases the intensity of the symptoms
• Very cold or scorching temperatures can temporarily increase the tremors
• Smoking cigarettes can also worsen the symptoms.

Possible Complication Of Essential Tremor

Essential tremors do not cause any other problems. It does not spread to internal organs. It only affects neuronal cells in certain parts of the nervous system. The damage to those areas can progress. As the condition progress, the severity of symptoms may become worse. Some other symptoms, like problems with posture, gait, etc., can appear as the condition progresses. However, it is not a life-threatening condition.

Prevention of Essential Tremor

Primary Prevention

• There are no primary prevention methods to reduce the risk of essential tremors
• Most factors like age and family history/genetic mutations are not preventable
• Get your thyroid levels regularly checked
• If you have a family history, consult a doctor before the symptoms show up, or you are just starting to notice them

Secondary Prevention

A few of the things we can do to either lower the intensity of the tremors and not worsen the condition are

• Do not drink caffeinated products, which can worsen the tremors
• Avoid drinking excessive amounts of alcohol
• Try to reduce the amount of stress. Try things that can help you with reducing stress
• Try not to smoke cigarettes
• Avoid excessive physical stress or fatigue

Differential Diagnosis of Essential Tremor

Essential tremors are often mistaken for another condition called Parkinson's disease. This condition is also a nervous system disorder, and it also presents with involuntary tremors or movements that are similar to essential tremors. However, there is an underlying cause for Parkinson's disease. Essential tremors, on the other side, do not have particular underlying conditions or symptoms. These are entirely different disorders.

Epidemiology

Essential tremors are more prevalent than other conditions like Parkinson's disease. It usually occurs in around 3 to 4 per every 1000 people. It is more common as age advances, although it has been seen in children. Family history is most common in the younger population with essential tremors. Gender has not been relevant for this condition.

Prognosis

Expected Prognosis

Even though essential tremor is not a life-threatening condition, it can make daily tasks harder to perform. It affects the person's ability to perform specific tasks or activities of daily life. The frequency of tremors may decrease as the person ages, but the severity increases.

Natural Progression

Most commonly, tremors affecting the hands or arms can progress slowly compared to other areas like the head or voice. It is a generally progressive disorder. But the rate at which it progresses is slow on average. Some studies have concluded that the average rate of progression is approximately 1.5 to 5% every year.

Pathophysiology

In essential tremor, certain parts of the brain and nervous system degenerate and causes dysfunction. It leads to the degeneration of neurons in those regions. Degeneration happens when specific receptors in the brain do not work correctly and do not provide the required stimulation. It results in the misfiring of nerve cells, causing tremors.