Essential tremor (ET) is among the most common neurological disorders. Characterized by rhythmic shaking, it primarily affects the hands but can also involve the head, voice, and other parts of the body. Although it is benign, meaning it doesn’t lead to life-threatening conditions like Parkinson’s disease, its impact on daily tasks and quality of life can be significant.
Everyday actions such as drinking, eating, writing, or dressing can become challenging, leading to frustration and self-consciousness among those affected.
Causes and Symptoms:
The exact cause of essential tremor remains uncertain. However, it seems to run in families, suggesting a genetic component. Some studies have identified potential genetic mutations that could be linked to ET, but these findings are yet to be conclusive.
The primary symptom is the involuntary shaking or tremor, which:
- Is rhythmic: Typically, the tremor involves a back-and-forth movement.
- Worsens with movement: The tremor becomes more pronounced when the affected body part is being used. This is termed as an “action tremor.”
- May improve with rest: When the affected body part is at rest, the tremor might reduce or disappear.
- Might get worse over time: While the progression is usually slow, over time the tremor can become more noticeable and disruptive.
- Can affect both sides of the body: However, it might be more pronounced in one side.
Other than the shaking, people with ET typically do not have any other neurological symptoms. However, in some cases, there may be problems with balance.
Treatment Options:
Treatment for essential tremor is individualized, focusing on alleviating the symptoms and improving functionality in daily life. Medications like propranolol and primidone are among the most prescribed. However, some patients do not respond to medications or experience adverse side effects.
In cases where medication is not effective or suitable, alternative treatments may be recommended:
- Deep Brain Stimulation (DBS): It involves implanting an electrode into the brain. The electrode emits electrical impulses that can interrupt signals causing tremors.
- Botox Injections: These can be used, especially for tremors in the hand or voice. Botox works by blocking nerve signals, leading to muscle relaxation and reduction in tremor.
- MR-Guided Focused Ultrasound: A newer and non-invasive approach to treat essential tremor is MR-guided focused ultrasound. This technique harnesses the power of precise, high-intensity ultrasound waves to target specific brain tissue responsible for the tremor. Magnetic resonance imaging (MRI) is used to guide the ultrasound beams to the exact location in the brain, ensuring precision. The focused energy heats and destroys the targeted tissue, leading to tremor reduction. Since there is no incision, the risks of infections or complications are lower. Multiple studies have shown promising results with significant reductions in tremor severity and improved quality of life.
Conclusion:
Essential tremor, while benign, can pose significant challenges in daily life for those affected. While medications are the primary mode of treatment, alternative therapies, particularly MR-guided focused ultrasound, offer hope for those seeking non-invasive and effective interventions. As research progresses, there’s optimism that more advanced and targeted treatments will emerge, improving the lives of those living with ET.
