Essential tremor

movement disorder causing involuntary tremors, especially in the hand

Essential tremor (ET), also called benign tremor, familial tremor, and idiopathic tremor, is a disorder of the nervous system that causes the patient to experience involuntary movements, producing involuntary and rhythmic jerks. It often affects the hands, although it can sometimes affect the voice or the head. Although it is the most common type of tremor, its causes have not yet been identified. It is not usually a dangerous condition, but essential tremor can progress over time, worsening the patient's condition.[7]

Essential tremor
Other namesIdiopathic tremor
Archimedean spiral drawings from a man with a unilateral essential tremor. The spiral on the left was drawn by the subject using the left hand, and the one on the right using the right hand.
SpecialtyNeurology
Usual onsetAny age, but typically after 40[1]
CausesUnknown[1]
Risk factorsFamily history, exposure to particular toxins[2]
Diagnostic methodBased on symptoms[3]
Differential diagnosisCerebellar tremor, dystonic tremor, multiple sclerosis, Parkinson's disease[4]
TreatmentMedications, surgery[5]
MedicationBeta blockers, primidone, anti-epileptics, topiramate, gabapentin, levetiracetam, benzodiazepines[5]
FrequencyAnnual incidence of 23.7 per 100,000 (2010)[6]

Essential tremor is a progressive[8][9][10] neurological disorder, and the most common movement disorder. Its onset is usually after age 40, but it can occur at any age.[1] The cause is unknown. Diagnosis is by observing the typical pattern of the tremor coupled with the exclusion of known causes of such a tremor.

Causes change

During maturation, a process occurs that involves progressive neurodegeneration and/or the death of neurons. This process, which can be normal and natural during normal aging, involves the fundamental cells of the nervous tissue and its internal components, which are the ones that prevent effectiveness in conducting information in the human brain, with the appearance of tremors, such as in Parkinson's disease. Essential tremor is the result of abnormal communication between certain areas of the brain, including the cerebellum, thalamus, and brainstem.

Features change

This ailment affects men and women, being more frequent in people over 65 years of age. Although the exact cause of essential tremor is unknown, some work indicates that the part of the brain that controls muscle movements does not work correctly in patients with essential tremor. Half of the cases of essential tremor are the consequence of a genetic mutation, although the specific gene has not been identified. This type is called familial tremor. It is unknown what causes essential tremor in people who do not have a genetic mutation.

Diagnosis change

The diagnosis is usually made on clinical grounds. Tremors can begin at any age, from birth to old age (senile tremor). Any voluntary muscle in the body can be affected, although tremor is most commonly seen in the hands and arms and slightly less on the neck (which makes the person's head move), tongue, and legs. A resting tremor of the hands is sometimes present. Tremor occurring in the legs may be diagnosed as orthostatic tremor.

ET occurs within multiple neurological disorders in addition to Parkinson's disease. This includes migraine disorders, where co-occurrences between ET and migraines have been examined.[11]

Treatment change

Essential tremor is usually treated with medication.

References change

  1. 1.0 1.1 1.2 Kivi R (2012-08-07). "What is essential tremor?". Healthline. Retrieved 17 June 2018.
  2. Louis ED, Zheng W, Mao X, Shungu DC (August 2007). "Blood harmane is correlated with cerebellar metabolism in essential tremor: a pilot study". Neurology. 69 (6): 515–20. doi:10.1212/01.wnl.0000266663.27398.9f. PMID 17679670. S2CID 7612446.
  3. "Essential Tremor Treatment at the Johns Hopkins Movement Disorders Center in Baltimore, MD". hopkinsmedicine.org. Retrieved October 27, 2014.
  4. Bhidayasiri R (December 2005). "Differential diagnosis of common tremor syndromes". Postgraduate Medical Journal. 81 (962): 756–62. doi:10.1136/pgmj.2005.032979. PMC 1743400. PMID 16344298.
  5. 5.0 5.1 Abboud H, Ahmed A, Fernandez HH (December 2011). "Essential tremor: choosing the right management plan for your patient". Cleveland Clinic Journal of Medicine. 78 (12): 821–8. doi:10.3949/ccjm.78a.10178. PMID 22135272. S2CID 58374.
  6. Zesiewicz TA, Chari A, Jahan I, Miller AM, Sullivan KL (September 2010). "Overview of essential tremor". Neuropsychiatric Disease and Treatment. 6: 401–8. doi:10.2147/ndt.s4795. PMC 2938289. PMID 20856604.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  7. "LINGO1 variant responsible for essential tremors and Parkinson's disease". news-medical.net. 2009-09-02. Retrieved October 27, 2014.
  8. Shukla AW. "Essential Tremor Information". Unified Health. Retrieved 17 June 2018.
  9. Louis ED. "Essential Tremor". National Organization for Rare Disorders. Archived from the original on 17 June 2018. Retrieved 17 June 2018.
  10. Gironell A, Ribosa-Nogué R, Gich I, Marin-Lahoz J, Pascual-Sedano B (2015). "Severity stages in essential tremor: a long-term retrospective study using the glass scale". Tremor and Other Hyperkinetic Movements. 5: 299. doi:10.7916/D8DV1HQC. PMC 4361372. PMID 25793146.
  11. Biary N, Koller W, Langenberg P (December 1990). "Correlation between essential tremor and migraine headache". Journal of Neurology, Neurosurgery, and Psychiatry. 53 (12): 1060–2. doi:10.1136/jnnp.53.12.1060. PMC 488315. PMID 2292698.