Essential Tremor Treatment in Delhi, India

Essential tremor is a neurological (related to the nervous system) condition that causes movement disorder or involuntary rhythmic shaking. While essential tremors can affect different parts of the body, trembling occurs mostly in the hands. Essential tremor is not life-threatening, but it obstructs a person from doing daily chores like eating, drinking from a cup or glass, tying shoelaces, writing, dressing, and so on.

Associated Anatomy of Essential Tremor

Essential tremor generally affects the hands, arms, larynx (voice box), head, chin, and tongue. The lower parts of the body are rarely involved.

Essential Tremor Causes

Doctors and scientists have not found the exact cause of essential tremors. No genetic, environmental, or cellular condition has been linked to essential tremor.

Essential Tremor Symptoms

The signs and symptoms of essential tremor include:

• The tremors affect the hands first.
• Nodding or shaking head.
• Tremors that worsen with fatigue, emotional stress, extreme temperatures, or caffeine.
• Tremors that subside with resting.
• Problems in balancing (in rare cases.)
• Twitching eyelids and other parts of your face. 
• Shakier voice, caused by tremors in the voice box or the tongue.
• Tremors in the core, feet, and legs can disrupt your gait (your style of walking.)

A few factors that can worsen your tremors temporarily

• Emotional stress.
• Hunger.
• Fatigue.
• Extreme temperatures (both hot and cold.)
• Caffeinated drinks.
• Smoking habits (cigarettes.)

Essential Tremor Diagnosis

In order to diagnose essential tremor the following tests must be prescribed:

Neurological examination

Your doctor will test the functioning of your nervous system by checking the following:

• Tendon reflexes
• Gait
• Muscle tone and strength
• Posture and coordination
• Ability to feel sensations

Laboratory Tests

Your urine and blood will be tested for the following factors:

• Thyroid disease.
• Drug side effects.
• Metabolic problems.
• Levels of the tremor causing chemicals.

Performance Tests

To determine the degree of tremor, your doctor might ask you to do the following activities:

• Write something.
• Drink from a cup and glass.
• Outstretch and hold your arms.
• Sketch spiral lines or figure.

Essential Tremor Treatment

If essential tremor leads to social problems and the symptoms lead to everyday crises, you can be treated with medications or surgery. Your options include:

Medications

Oral drugs can help in easing essential tremor symptoms. They include primidone (Mysoline), gabapentin (Neurontin), topiramate (Topamax), and propranolol (Hemangeol, Inderal, InnoPran XL). A few more drug options include clonazepam (Klonopin), benzodiazepines alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium). Apart from this, botox shots are effective treatments for head and vocal tremors.

Adaptive Devices

External adaptive devices like neuromodulation devices and tremor cancellation devices help in controlling the severity of tremors.

Deep Brain Stimulation (DBS)

Deep Brain Stimulation (DBS) is a surgical process wherein an electrode is implanted in the thalamus and is attached to a pacemaker-type device that rests under the skin of the chest. This device releases small, painless shocks that counter faulty electrical messages in the brain.

Magnetic Resonance Imaging (MRI) guided focused ultrasound

This high-intensity ultrasound uses MRI to focus ultrasound and further destroy tissues of the thalamus. This painless procedure does not require any drilling or cutting into the brain.

Thalamotomy

This surgical process is undertaken to destroy certain parts of the thalamus. The procedure is typically carried out on only one side of the brain.

Biomechanical Loading

Performed by carrying out external forces to a muscle or limb, biomechanical loading helps in controlling tremors.

Risk Factors of Essential Tremor

A few known risk factors include:

• Genetic Mutation: If your one parent has a genetic mutation for essential tremor, there are 50 percent chances that you will inherit the disorder.

• Age Essential Tremor: It affects people who are over 40 years.

Possible Complications of Essential Tremor

Essential tremor doesn’t put your life at risk, but as the symptoms will worsen over time, it will lead to difficulties like:

• A problem in holding a glass or cup without spilling the content.
• Failing to eat normally.
• Difficulty in applying makeup and shaving.
• Talking disability (if your tongue or voice box is affected).
• Trouble in writing legibly.

Essential Tremor Prevention

Primary Prevention

Since the cause of essential tremor remains unknown, there are no fool-proof ways to prevent it.

Secondary Prevention

After being diagnosed with essential tremors one can lead a normal life. However, if your tremors are severe, certain adjustments and prevention can help you in staying safe:

• Opt for slip-on shoes.
• Use a hook to fasten buttons.
• Consider using straws to drink from glasses and cups.
• Switch to an electric razor and avoid a manual one.

Epidemiology of Essential Tremor

Essential tremor is common in adults, especially those who are 40 and older.

Expected Prognosis of Essential Tremor

Essential tremor is not life-threatening, but it can be difficult for the person in performing daily activities. Moreover, tremors cause embarrassment in social settings. Furthermore, the frequency of tremors might decrease with age but its severity might increase.

Natural Progression of Essential Tremor

The expected progression in essential tremors is building up more types of tremors with time, for instance, rest tremor, intention tremor, and head tremor. However, these features will not appear in every essential tremor patient-it will differ from patient to patient depending on the development of these features.

Moreover, an untreated essential tremor can lead to other illnesses like movement disorders, Parkinson's disease, migraine headaches, and dementia (particularly Alzheimer’s disease).

Related Blogs

• Parkinson’s Disease: Symptoms & How to Prevent It
• Robotic Surgery in Uterine Cancer: Advancements and Benefits
• Alzheimer's Disease Cause, Detection and Treatment
• Know Myths And Facts About Alzheimers Disease