Causes and risk factors
The exact cause of essential tremor is not known. Expert suggests that changes in specific part of brain or impaired electrical activity in the brain tissue may cause essential tremors. Familial tremor [presence of essential tremor in more than one family member] can be inherited. Essential tremor is more common in people above 40 years of age. Essential tremors may present in associated illnesses like Parkinson’s disease, Alzheimer’s disease and other neurological disorders. Metabolic diseases like thyroid disease, hypertension, and diabetes mellitus can exhibit essential tremors. Contributing factors for the tremors include alcohol, tobacco, smoking etc.
Clinical presentation
Patients with essential tremors present with only tremors. Associated symptoms such as loss of balance may be present. Tremors begin in upper extremity and then affect the other extremity. The tremors then extend to ipsilateral [same side] lower extremity. They are intermittent tremors but may become persistent over a period of time. Tremors may affect head, lips, jaw, and face. Shaking of voice is also observed. Symptoms of essential tremors include uncontrollable shaking that occurs for brief period of time; tremor is worse form mental or physical stress, movement and reduces with rest, difficulty in performing daily task like writing, feeding, dressing and activities of personal hygiene. Nodding of head is observed.
Investigation
Medical history by the patient and Clinical examination by the neurologist helps in diagnosis. Neurological testing is recommended. Blood and urine test is advised for thyroid disease, metabolic problems, alcohol levels, levels of toxic chemicals that can cause tremors.
Treatment
Mild tremors do not require treatment. However if the tremor is affecting your day to day life then treatment is necessary. Treatment options include medicines like anti-seizure medications, Tranquilizers. Botox injections may be useful. Deep brain stimulation is the treatment option for people who do not respond to medical treatment. Stereotactic radiosurgery contribute further to the treatment. Adequate rest, relaxation therapies, avoiding stimulants like caffeine will also help in managing essential tremors.
Other Modes of treatment
The other modes of treatment can also be effective in treating essential tremors. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating essential tremors.
