essential tremor 3

Essential Tremor: A Description

Essential tremor (ET) is a neurological disorder that causes involuntary and rhythmic shaking or trembling in various parts of the body, most commonly in the hands, head, trunk, voice, or legs. This condition is often confused with Parkinson's disease, but it is actually the most common type of trembling disorder.

• Symptoms: ET can cause tremors to occur during activity (action tremor) and are less noticeable at rest. The tremors may worsen with caffeine, stress, or certain medications.
• Affected Areas: The upper limbs (hands) are affected in about 95% of patients, while the head, face/jaw, voice, tongue, trunk, and lower limbs can also be involved.
• Progression: ET is usually a progressive condition, meaning it gets worse over time. However, this progression is typically slow, with an average rate of worsening between 1.5% to 5% per year.

Key Points

• Essential tremor is the most common type of trembling disorder [3][4].
• It is often confused with Parkinson's disease, but they are distinct conditions.
• ET can affect various parts of the body, including the hands, head, trunk, voice, or legs.
• The condition is usually progressive, meaning it gets worse over time.

References

[3] Essential tremor (ET) is a neurological disorder that causes involuntary and rhythmic shaking. [1] [4] ET is often confused with Parkinson's disease, but they are distinct conditions. [3]

Signs and Symptoms of Essential Tremor

Essential tremor is characterized by involuntary shaking or trembling movements in one or more parts of the body, most commonly affecting the hands, arms, head, chin, and voice box. The symptoms can vary from person to person, but here are some common signs and symptoms:

• Tremors: The most obvious symptom of essential tremor is a rhythmic tremor in the hands, arms, head, or voice.
• Difficulty with daily activities: People with essential tremor may experience difficulty performing tasks that require hand coordination, such as writing, using tools, or even holding a cup.
• Progressive symptoms: Essential tremor is usually progressive, meaning it gets worse over time. The average rate of progression is between 1.5% and 5% per year.
• Symptoms may spread: Over time, the tremors may spread to affect other parts of the body, such as the arm or head.

According to [3], essential tremor typically affects both hands, but one side often shows more symptoms. Symptoms may be mild at first and may come and go. It's essential to note that essential tremor is not Parkinson's disease, although it can share some similar symptoms (see [1]).

In some cases, people with essential tremor may experience other neurological signs and symptoms, such as an unsteady walk or difficulty with balance (see [2]). However, these symptoms are less common and typically occur in more advanced stages of the condition.

Diagnostic Tests for Essential Tremor

Essential tremor diagnosis typically involves a physical examination and clinical observation, as there are no specific medical tests to diagnose the condition [1]. Other tests can rule out other conditions that may cause similar symptoms. Here's what you need to know about diagnostic tests for essential tremor:

• Clinical Examination: A thorough physical examination by an experienced clinician is crucial in diagnosing essential tremor [7].
• Blood and Urine Tests: These tests are used to check for signs of infections, genetic disorders, or other conditions that may be causing symptoms [8].
• Dopamine Imaging: This test can help rule out other conditions such as Parkinson's disease.
• Electromyography (EMG) or Accelerometry: These tests can assess tremor frequency, rhythmicity, and amplitude but are not part of the routine evaluation [6].

Important Note

Imaging tests like MRI and CT scans are not helpful in diagnosing essential tremor [13]. The diagnosis is usually based on clinical examination and observation.

Additional Information

Essential tremor can be diagnosed by appearance of shaking and trembling during a comprehensive neurological examination [7]. It's essential to rule out other conditions that may cause similar symptoms.

Medications Used to Treat Essential Tremor

Essential tremor can be effectively managed with various medications, which are often used in combination with other treatments such as physical therapy and lifestyle modifications.

• Beta-adrenergic blockers (beta blockers): These medications, including propranolol, are commonly prescribed to treat essential tremor. They work by blocking the effects of adrenaline on the body, which can help reduce tremors.
• Anti-seizure medications: Certain anti-seizure medications, such as primidone and topiramate, have been found to be effective in reducing tremors associated with essential tremor.

These medications are often used to manage symptoms and improve quality of life for individuals with essential tremor. However, it's essential to consult a healthcare professional to determine the best course of treatment for your specific needs.

References: * [5] Medications commonly used to treat essential tremor include beta-adrenergic blockers (beta blockers), such as propranolol, and the anti-seizure medication primidone. * [8] Drugs most commonly used to treat the condition include beta-blockers such as propranolol and an epilepsy drug called primidone.

Essential Tremor Differential Diagnosis

Essential tremor (ET) is a common movement disorder that can be challenging to diagnose, as it shares similar symptoms with other conditions. A thorough differential diagnosis is crucial to rule out other potential causes and ensure accurate treatment.

Common Conditions to Consider:

• Exaggerated Physiologic Tremor: This condition is characterized by an increased tremor amplitude due to various factors such as stress, fatigue, or certain medications. It can be a normal variant in some individuals.
  • [1] reports that exaggerated physiologic tremor was the most common diagnosis (9.5%), followed by essential tremor (3.0%).
• Parkinsonian Tremor: This type of tremor is often associated with Parkinson's disease, but can also occur independently. It typically involves a resting tremor and rigidity.
  • [2] notes that parkinsonian tremor was the second most common diagnosis (2.8%) after essential tremor.
• Cerebellar Tremor: This condition is caused by damage to the cerebellum, often due to stroke or tumor. It can manifest as a kinetic tremor with ataxia and dysarthria.
  • [1] reports that cerebellar tremor was the least common diagnosis (0.2%).
• Dystonic Tremor: This type of tremor is associated with dystonia, a movement disorder characterized by involuntary muscle contractions.
  • [4] lists dystonic tremor as one of the differential diagnoses for essential tremor.

Other Conditions to Consider:

• Psychogenic Tremor: This condition is caused by psychological factors such as anxiety or stress. It can manifest as a voluntary oscillation or