Symptoms of Essential Tremor |
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What are the symptoms of essential tremor?
If you have essential tremor, you will have shaking and trembling at different times and in different situations, but some characteristics are common to all. Here is what you might typically experience:
- Tremors occur when you move and are less noticeable when you rest.
- Tremors can begin in one hand and progress to both hands.
- Certain medicines, caffeine or stress can make your tremors worse.
- Tremors may improve with ingestion of a small amount of alcohol (such as wine).
- Tremors get worse as you age.
- Tremors that are most obvious in your hands.
- Difficulty doing tasks with your hands, such as writing or using tools.
- Shaking or quivering sound in your voice.
- Uncontrollable head-nodding, yes-yes or no-no motion of the head.
- In some instances, tremors in your legs or feet.
- Begin gradually, usually more prominently on one side of the body.
- May be aggravated by emotional stress, fatigue, caffeine, or temperature extremes.
Never heard of essential tremor?
Perhaps it's because so many other conditions compete for headlines. Advocates for people with ET have not had the benefit of a celebrity spokesperson such as Michael J. Fox or Muhammad Ali, who both have Parkinson's disease. The most famous person with ET was the late actress Katherine Hepburn, who parlayed her disorder into an intriguing component of both her vocal and on-screen personae. Other notables with ET include retired Supreme Court Justice Sandra Day O'Connor and the late West Virginia Senator Robert Byrd, who passed away last summer.
Although the disease is not fatal, it can cause severe disability.
WHAT IS ESSENTIAL TREMOR? Essential tremor is a progressive neurologic condition that causes involuntary rhythmic trembling of the hands, head, tongue, voice, and less often the legs or trunk. Like Parkinson's disease, ET is considered a movement disorder. The disease is caused by abnormal communication—sometimes called a “misfire”—between certain areas of the brain including the cerebellum, thalamus, and brain stem.
Tremors may be more prominent when the person is highly active or anxious. A vicious circle can occur with ET: The person fears embarrassment in public, which in turn makes the tremor worse. As a result, people with ET may limit social interaction and even develop social phobia. Sometimes, observers assume the tremor is due to drug or alcohol intoxication.
“Essential tremor can cause significant disability. In addition, tremor tends to worsen with age.
NOT THAT BAD—OR IS IT? But health care professionals actually wish more people with ET would speak up about their condition.
It's clear from studies that the majority of patients have not been to a doctor or diagnosed.The reason may be that the condition is initially mild—in fact, ET may remain mild for decades—or because a family member has ET and relatives become used to it.
“Often as patients approach retirement or late middle age, the tremors become more noticeable
COMMONLY MISDIAGNOSED Essential tremor can be easily misdiagnosed as another movement disorder, most frequently Parkinson's disease. Essential tremor actually occurs eight times more often than Parkinson's. A handwriting test is often used to distinguish between the two, says Dr. Lyons. “Essential tremor often results in large, shaky handwriting samples. Parkinson's writing typically starts out normal, then gets smaller and smaller.”
Tremors of the voice and head also do not generally occur in Parkinson's but are commonly seen with ET. A patient suspected of ET should be examined while in a reclined or seated position with complete body support.
Dystonic tremor is also often confused with ET. Patients with dystonia exhibit an abnormal, involuntary spasm or contraction of muscles in the face, neck, hand, or torso. When muscles aren't used, they normally relax. With dystonia they do not, resulting in abnormal postures.
General neurologists treating tremor have a diagnostic error rate of 25 percent to 35 percent. “There is no laboratory test for ET, no biological marker to diagnose it.
Perhaps it's because so many other conditions compete for headlines. Advocates for people with ET have not had the benefit of a celebrity spokesperson such as Michael J. Fox or Muhammad Ali, who both have Parkinson's disease. The most famous person with ET was the late actress Katherine Hepburn, who parlayed her disorder into an intriguing component of both her vocal and on-screen personae. Other notables with ET include retired Supreme Court Justice Sandra Day O'Connor and the late West Virginia Senator Robert Byrd, who passed away last summer.
Although the disease is not fatal, it can cause severe disability.
WHAT IS ESSENTIAL TREMOR? Essential tremor is a progressive neurologic condition that causes involuntary rhythmic trembling of the hands, head, tongue, voice, and less often the legs or trunk. Like Parkinson's disease, ET is considered a movement disorder. The disease is caused by abnormal communication—sometimes called a “misfire”—between certain areas of the brain including the cerebellum, thalamus, and brain stem.
Tremors may be more prominent when the person is highly active or anxious. A vicious circle can occur with ET: The person fears embarrassment in public, which in turn makes the tremor worse. As a result, people with ET may limit social interaction and even develop social phobia. Sometimes, observers assume the tremor is due to drug or alcohol intoxication.
“Essential tremor can cause significant disability. In addition, tremor tends to worsen with age.
NOT THAT BAD—OR IS IT? But health care professionals actually wish more people with ET would speak up about their condition.
It's clear from studies that the majority of patients have not been to a doctor or diagnosed.The reason may be that the condition is initially mild—in fact, ET may remain mild for decades—or because a family member has ET and relatives become used to it.
“Often as patients approach retirement or late middle age, the tremors become more noticeable
COMMONLY MISDIAGNOSED Essential tremor can be easily misdiagnosed as another movement disorder, most frequently Parkinson's disease. Essential tremor actually occurs eight times more often than Parkinson's. A handwriting test is often used to distinguish between the two, says Dr. Lyons. “Essential tremor often results in large, shaky handwriting samples. Parkinson's writing typically starts out normal, then gets smaller and smaller.”
Tremors of the voice and head also do not generally occur in Parkinson's but are commonly seen with ET. A patient suspected of ET should be examined while in a reclined or seated position with complete body support.
Dystonic tremor is also often confused with ET. Patients with dystonia exhibit an abnormal, involuntary spasm or contraction of muscles in the face, neck, hand, or torso. When muscles aren't used, they normally relax. With dystonia they do not, resulting in abnormal postures.
General neurologists treating tremor have a diagnostic error rate of 25 percent to 35 percent. “There is no laboratory test for ET, no biological marker to diagnose it.