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| Is It Essential Tremor or Parkinson's Disease? |
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In This Essential Tremor Article:
Introduction to Essential Tremor
"We usually hear a family history with essential tremor," says Dr. Neal Hermanowicz, director of the movement disorders program at the University of California, Irvine, and professor of neurology. "In fact, we believe about 40 percent of the cases are hereditary but it's still not a clear-cut gene. While not as troubling as Parkinson's, some patients have a very difficult time because the tremor interferes with basic tasks. They give up eating in restaurants or signing checks, for example." A recent discussion in this column about the potential benefits of brain-stimulation procedures in connection with controlling Parkinson's symptoms led to several reader inquiries asking for more details on essential tremor.
How do you know if a patient has essential tremor or Parkinson's? It's true some people have a similar tremor with Parkinson's that can present diagnosis difficulties even for expert clinicians. But we now have brain scan procedures to help with the diagnosis and shed more light on the problem. They are new and not available everywhere and I am not saying every patient needs one. The diagnosis for essential tremor also can be made by carefully listening to the symptoms, in most cases. In a typical case of essential tremor, the patient observes a gradual onset of tremor in both hands. Parkinson's is usually one side or the other. Essential tremor shows up typically when the patient is doing a task. With Parkinson's, the tremor could show only when the hand is at rest. Of course, the medications for essential tremor and Parkinson's diseases are different.
What is A Deep-Brain Stimulation Procedure?
Essential tremor and Parkinson's Disease are treated by deep-brain stimulation but we target different parts of the brain for each disease. Because there is a difference between Parkinson's and essential tremor, it's important to select patients for deep-brain stimulation very carefully. As previously mentioned, the Deep-brain stimulation procedure is not for everyone.
Are there risks associated with deep-brain stimulation? Of course. It's reasonable to have a discussion about deep-brain procedure early in the process but the risks must be outlined. And they include the possibility of a stroke. Not all Parkinson's patients respond to deep-brain stimulation. We need to be clear about what can be achieved. It's always an elective procedure.
Let's go back to the brain scan we mentioned. Does it help refine the diagnosis?
Certainly. Tremors - whether essential tremor or Parkinson's, can change very gradually as time goes by. In fact, gradual change is most typical.
About the Author:
Jane Glenn Haas is a multi-media personality – a newspaper writer, national columnist, book author, television host, professional speaker and founder of WomanSage, a non-profit organization dedicated to empowering, educating and fostering mentoring relationships among women at midlife. Jane has been twice nominated for the Pulitzer Prize, she has been honored for Excellence in Aging Reporting with the Hugh Downs Award of the International Longevity Center; the American Society on Aging Media Award; the American Medical Writers Association Rose Kushner Award; the American Heart Association C. Everett Koop Award; the Alzheimer’s Association Rosemary Award, and many others.
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Do you remember when your grandma had "shaky" hands. Or maybe it was your favorite uncle? They most likely suffered from essential tremor, a condition usually associated with age and often confused with Parkinson's disease.
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