Health Report

IN last week’s issue I highlighted tremors, ‘shakes’ in general and the spectrum of different diseases they might be caused by. This ranges from the very benign and non-life-altering such as essential tremor to the very serious and life changing Parkinson’s disease.

Most people fear the worst when they notice tremors in themselves or their loved ones. You just have to keep in mind that not all shakes are serious as some are a normal physiological response. These physiological tremors are usually exacerbated by certain things such as caffeine or anxiety.

In today’s article I will be concentrating on the benign essential tremor which is, to an extent, a non-serious condition that usually runs in families and may cause no problems at all. Essential tremor is described as uncontrolled shaking movements in parts of your body commonly involving the arms and hands.

The key feature here is that the movements are uncontrollable and you will notice that you don’t do them intentionally. It is often felt as trembling. Like I mentioned above, some tremors are physiological.

Essential tremor is different from physiological tremors. It usually starts in the hands and arms and can sometimes become quite severe so that everyday activities like buttoning your shirt can be difficult.

The tremor is usually not there at rest but becomes noticeable when the affected body part is held in a steady position such as keeping the hands up forward, or with movement. The term ‘essential’ means that there is no associated disease that causes the tremor.

Usually it is mild and does not impair usual daily function, however, in some cases it can be severe enough to cause disruption to daily activities and this is when medical or surgical treatment is needed.

The chance of developing such tremor increases with age and it usually runs in families. At least five to seven out of 10 people with essential tremor have other members of the family with the same condition. 

Certain genes which have not yet been clearly identified are passed from parents to their children. It is pretty common with about five in 1,000 people being affected with equal chance of occurring in men and women.

In essential tremor, the tremor usually begins in one arm or hand. It usually starts to involve the other side in one to two years and sometimes even involving the legs or head.

There is no test to diagnose essential tremor. It is usually diagnosed with history and physical examination. Your doctor will try to exclude other causes for the tremor including Parkinson’s. This includes blood tests and a brain scan.

Essential tremors cannot be cured. The aim of treatment is reduction of the severity of the tremor. If your tremor is mild, you may not need any treatment. If the tremor is more severe, then certain medications like propranolol or primidone can be used.

If medicine treatment is not effective, and the tremor is severe, then a surgical procedure may be an option. This includes electronic signal stimulation in the brain and surgical procedures to certain parts of the brain.

Essential tremor is called a progressive disease. This means that it tends to worsen over time. It does not shorten the expected lifespan and does not lead to any more serious brain illnesses.

You should always seek medical attention when you notice a tremor that is worrying especially if it’s worsening and affecting your daily life activities. Diagnosing the tremor type is half the battle as it can be tricky.

In the coming weeks, I will focus on Parkinson’s disease, which is a common cause of tremor that unlike essential tremor is serious and can reduce life expectancy.