Essential Tremor: Causes, Symptoms, Diagnosis, and Treatment

Shaking of hands while holding a coffee cup, trembling while applying makeup, and difficulty while dealing with machinery, all of these are pretty common observations. Scientifically known as “essential tremor”, this is a neurological problem, that leads to rhythmic shaking of various body parts. Although the frequency of occurrence is higher in populations above the age of 50, the disorder can strike all age groups. 

Many people have refrained from getting adequate care since the general population is ignorant about this illness. Moreover, the stigmas associated do not help the situation. Thus it’s necessary to spread awareness on this topic. 

Understanding Essential Tremor

A sort of uncontrollable shaking movement is an essential tremor. If you tremble unintentionally and are unable to stop it on your own, you are shaking involuntarily. The most often afflicted body parts are the hands and forearms. According to recent research, the occurrence is around 3% in people above 80 years. Besides, 24.91 million people were affected in 2020, 56% of them being men. 

No exact cause has been identified behind essential tremors. Some believe it’s triggered by problems in brain electrical activity, However, a genetic link has been observed, where the disorder gets passed on through the family (called familial tremor). Causes such as alcohol abuse, stroke, and hyperthyroidism have been speculated. 

Symptoms 

The following signs of essential tremor can be found in various body parts:

• If the tremor impacts the hands, it may be difficult to write, draw, sip from a cup, or even use tools.
• Twitching may be observed in facial regions, such as eyelids.
• Tremors in the head or neck.
• Problems with movement or balance.

When faced with worry, excitement, or stressful circumstances, the tremors can grow more noticeable.

Diagnosis 

There is no specific test to diagnose essential tremors. Usually, the doctor analyzes the medical history and symptoms observed and concludes. 

Some common tests to rule out other possibilities are:

• There is a nervous system examination, checking for posture, reflexes of body parts, muscle strength, coordination, etc. 
• Blood and urine tests are suggested to cancel other possibilities such as thyroid disorders, side effects of drug or alcohol abuse, metabolic diseases, etc. 
• The doctor may ask to draw a spiral or hold a cup with the arm fully stretched out, confirming proper motor skills. 

Often people confuse essential tremors with a similar type of shaking in Parkinson’s disease. A dopamine transporter scan may be conducted to find out the difference and diagnose the condition. 

Treatment Options

Many people have no to very mild essential tremors, which is quite manageable. However, a treatment plan is necessary when daily activities are being compromised due to the condition. 

A few medications effective for essential tremors are:

• Propranolol - A beta-blocker which can lessen tremors by preventing adrenaline's effects on the body. It is frequently the initial course of action for ET.

• Topiramate - An anticonvulsant drug that has been discovered to lessen tremors in some ET patients.
  
• Clonazepam - A benzodiazepine drug that works by raising the brain's GABA concentrations to lessen tremors.

• Primidone - A drug that raises the brain's neurotransmitters such as GABA to lessen tremors. Moreover, it serves as the first-line therapy for ET.

Apart from this, therapy is another option. One can learn exercises from physical therapists to strengthen, regulate, and coordinate the muscles.

If the tremors are severe, surgery is the final option. The two types are:

• Focused Ultrasound Thalamotomy: A non-invasive surgery, it uses sound waves to target and strike a particular brain region (in the thalamus). Tissues get destroyed, stopping tremors. The presence of an expert surgeon is mandatory to target the correct brain area, with the perfect amount of heat from sound waves. 

Impact of Essential Tremors

A person's psychological as well as emotional health can be significantly impacted by essential tremors (ET). Because of the shame, irritation, and social alienation that can result from having a visible illness, ET can lead to anxiety and depression. An increase in these feelings may trigger severe tremors. 

Because of their self-consciousness about their tremors, individuals with ET may steer clear of social settings or activities that they find enjoyable. Relationships with love partners, family members, and friends can all be impacted by ET. Tremors can be challenging to explain or manage, which can result in confusion and disputes. 

Even professional life can get impacted. Individuals with ET may find it extremely challenging to thrive in careers requiring fine motor skills, such as the medical field, or where public speaking is involved. 

Empowering People with Essential Tremor

By now it’s quite clear, how ET affects people, lowering their quality of life. To raise public awareness of this widespread ailment, March marks National Essential Tremor Awareness Month. To empower people suffering from the condition, it’s important to increase awareness and get rid of unnecessary stigmas. This may be done in the following manner:

• Social media is a strong tool, which can be used to reach millions of people within seconds. It might be beneficial to raise public awareness of the disease by using tags like #EssentialTremor or #ETAwareness. In social media, sharing data, figures, and personal accounts may also assist in educating others.
  
• There are several events conducted such as fundraisers, walks, seminars, etc. dedicated to this cause. Greater participation in them means better reach. 
  
• Funding and support are required for effective research, to get better treatment options. Participating as volunteers in research studies or donating funds can be great options to support the cause. 

Summing Up

Although not life-threatening, essential tremors can become unmanageable and degrade the quality of life. Fortunately, there’s hope and effective treatment options for the patients. Living a happy life with ET is feasible with the correct management and treatment techniques. Together, let us can create a society where individuals with ET are acknowledged, supported, and given the tools, they need to lead fulfilling lives.