essential tremor 5

Essential Tremor Description

Essential tremor (ET) is characterized by a slowly progressive postural and/or kinetic tremor, which means that it can affect the hands or other parts of the body when they are at rest or in motion. This condition is often confused with Parkinson's disease, but it is not life-threatening and can usually be kept under control.

Key Features:

• Slowly progressive postural and/or kinetic tremor
• Affects hands or other parts of the body
• Can be mistaken for Parkinson's disease
• Not life-threatening
• Can be controlled with treatment

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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 a person's hands [5]. The symptoms can vary from person to person, but common signs include:

• Rhythmic tremor: A rhythmic shaking or trembling movement in the hands, arms, head, or voice
• Internal tremor: Feeling an internal tremor or vibration in the body

These symptoms

Diagnostic Tests for Essential Tremor

Essential tremor diagnosis involves ruling out other conditions that may cause similar symptoms. While there are no specific tests to diagnose essential tremor, several diagnostic tools can help healthcare providers make an accurate diagnosis.

• Imaging tests: MRI and CT scans are not typically helpful in diagnosing essential tremor but may be performed to rule out other possible causes of tremors [5].
• Spiral test: One test used to evaluate essential tremor involves drawing a spiral. This can help healthcare providers assess the severity and characteristics of the tremor [6].

It's worth noting that diagnostic testing for essential tremor is often focused on ruling out other conditions rather than confirming the diagnosis itself.

References:

[5] Imaging tests such as MRI and CT scans are not helpful in diagnosing Essential Tremor, but they may be performed to rule out other possible causes of tremors. [6] One test used to evaluate essential tremor involves drawing a spiral. The spiral on the left was drawn by someone affected by essential tremor.

Medications Used to Treat Essential Tremor

According to various sources, medications are commonly used to treat essential tremor. The most commonly used drugs include:

• Beta-blockers: Such as propranolol (Hemangeol, Inderal LA, Inderal XL, InnoPran XL), which can help reduce the severity of tremors in some patients [5].
• Anti-seizure medications: Like primidone, which is sometimes used to treat essential tremor, although its effectiveness may vary among patients [12].

It's worth noting that patient responses to these medications can differ significantly, and not all individuals with essential tremor will experience relief from symptoms using these treatments.

Here are some potential differential diagnoses for Essential Tremor (ET):

1. Parkinson's Disease (PD): * Similarities: Both ET and PD can cause tremors, rigidity, bradykinesia, and postural instability. * Differences: PD typically presents with a resting tremor, whereas ET is characterized by an action or kinetic tremor. Additionally, PD often involves other motor symptoms like bradykinesia and postural instability.

2. Cerebellar Ataxias: * Similarities: Both ET and cerebellar ataxias can cause tremors, balance problems, and coordination issues. * Differences: Cerebellar ataxias typically involve more pronounced gait disturbances, dysarthria (speech difficulties), and nystagmus (eye movement abnormalities).

3. Orthostatic Tremor: * Similarities: Both ET and orthostatic tremor can cause tremors that worsen with standing. * Differences: Orthostatic tremor is characterized by a more pronounced tremor when standing, often accompanied by balance problems.

4. Wilson's Disease (Hepatolenticular Degeneration): * Similarities: Both ET and Wilson's disease can cause tremors, rigidity, and coordination issues. * Differences: Wilson's disease typically involves liver dysfunction, Kayser-Fleischer rings (copper deposits in the cornea), and psychiatric symptoms.

5. Neurodegenerative Disorders: * Similarities: Both ET and neurodegenerative disorders like Multiple System Atrophy (MSA) or Progressive Supranuclear Palsy (PSP) can cause tremors, rigidity, and coordination issues. * Differences: These conditions often involve more widespread motor symptoms, cognitive decline, and autonomic dysfunction.

6. Medication-Induced Tremor: * Similarities: Both ET and medication-induced tremor can cause tremors. * Differences: Medication-induced tremor is typically associated with the use of certain medications like beta-blockers, antidepressants, or antipsychotics.

7. Thyrotoxicosis (Hyperthyroidism): * Similarities: Both ET and thyrotoxicosis can cause tremors. * Differences: Thyrotoxicosis is characterized by symptoms like weight loss, heat intolerance, and tachycardia.

When evaluating a patient with suspected Essential Tremor, it's essential to consider these differential diagnoses and perform a thorough medical history, physical examination, and diagnostic testing (e.g., EMG, EEG, or imaging studies) to rule out other conditions.