What we call “tremors” is the most common movement disorder.
Medical and neurology professionals define it as an involuntary and rhythmic (approximately) movement of one or more parts of the body. Essential and kinetic tremors are some of the most common types of movement disorders.
To help you understand the details of essential and kinetic tremors, we’ll also need to examine other movement disorders and how they fit into the big picture.
What is an essential tremor?
An essential tremor is a mysterious neurological disorder that causes rhythmic shaking of the hands, legs, head, torso, or voice. Essential tremors are one of the most misdiagnosed neurodegenerative diseases, often mistaken as Parkinson’s disease.
Everyone, in fact, has some degree of tremor. These movements, however, cannot usually be seen or felt because the tremors are so small. When the tremors are noticeable, they are usually diagnosed as essential tremor, the most common trembling disorder.
Essential tremors can affect a person at any age, but are most commonly found among those 65 or older.
Symptoms of essential tremor
Tremors are more likely to be noticed in the hands and forearms. However, other muscle contractions can occur in many different parts of the body. The affected body part may have functional difficulties—like trouble holding cutlery or a pen.
Essential tremor shaking mostly happens with small, rapid movements that occur four to 12 times a second.
These symptoms could include:
- Shaking or quivering quality to a voice if the tremor is affecting the voice box
- Head nodding
- Problems using hand-held tools like pencils or cups for drinking if the tremors occur in the hands
The tremors themselves may also have these qualities:
- They occur during motion or movement. These may be less noticeable than other symptoms
- They periodically stop and start, but typically worsen with age
- Stress, lack of sleep, caffeine, and medications can worsen them
- They may not affect both sides of the body in the same manner
- Alcohol may slightly improve the tremors
Risk factors for essential tremor
The cause or causes of essential tremor are not known. A theory suggests the cerebellum, which is in charge of muscle coordination, is not communicating correctly with other parts of the brain. However, there is nothing conclusive as of yet.
Essential tremor seems to be passed down genetically through family ties. If at least one of a person’s parents has essential tremors, then there is a 50% chance that they or their children will inherit the gene responsible for the condition.
How do you treat essential tremor?
Unless the person has severe tremors, treatment is not usually required. However, if any essential tremor cases are making daily living difficult, there are treatment options that might decrease tremors.
- Beta-blockers can help relieve tremors so long as the patient doesn’t have asthma or certain heart issues
- Anti-seizure meds
- Tranquilizers are sometimes used if tension or anxiety makes the tremors worse. Caution: these can cause drowsiness and can be habit-forming
- Botox injections are sometimes used for voice or head tremors
Physical therapy can teach the person exercises that improve muscle strength, coordination and control. Occupational therapists might help them adapt to living with essential tremor. Specific adaptive devices can reduce the effects of tremors on daily activities, including:
- Weighted glasses and utensils
- Wrist weights
- Thicker, heavier writing tools such as wide-grip pens
Wearable nerve stimulation devices
A newer treatment for essential tremor, the stimulating device can be worn as a wristband for short periods twice a day for peripheral nerves and muscle response.
Surgery can be an option if tremors are severely disabling and are not responding to medications.
Deep brain stimulation
In difficult essential tremor cases, the most common surgical treatment is a thin electrical stimulation probe inserted into the brain’s thalamus. Then, a pacemaker-like device (neurostimulator) implanted in the chest transmits painless pulses that can interrupt the tremor signals.
Focused ultrasound thalamotomy
This noninvasive surgery uses focused sound waves traveling through the skull, creating a lesion in the thalamus to stop tremors. Magnetic resonance imaging can target the correct area.
For more information, consider contacting the Movement Disorder Society (specializing in Parkinson’s disease).
Other movement disorders similar to essential tremor
When evaluating someone with a tremor, the first step is to characterize the tremor.
Types of tremors can be determined clinically based on the action, frequency, and topographical distribution.
There are two main classifications of tremors: resting and action tremors—and these are subdivided into two sub-categories: postural and kinetic tremors.
Action tremors are the most prevalent of these types of tremors and occur during a sustained extension of the arm during voluntary movements like typing or writing.
On the other hand, a resting tremor occurs if the patient is sitting with their arms firmly supported and not involved with any voluntary movements.
A resting tremor is generally made worse by increased mental stress (like asking them to count backward), and the symptom decreases with voluntary movements.
The most common type of resting tremor is idiopathic Parkinson’s disease.
The most common postural and kinetic tremor is an essential tremor. Another action tremor is a physiological tremor, present in any healthy person under the right conditions.
Tremors can occur independently or as part of other syndromes like multiple sclerosis (MS), dystonia, or neuropathy. Let’s look at some of these other conditions to see how they are similar or different from essential tremors.
Dystonia tremors vary in their presentation and can look very much like essential tremors, but there are ways to tell them apart. In addition, the tremors accompanying dystonia are rarely the only symptom and usually associated with other body symptoms called dystonic body postures.
Essential tremor vs. Parkinson’s disease
There are some similarities between the tremors associated with Parkinson’s disease and essential tremors, but the main differences are:
- Parkinson’s disease will carry other symptoms like stooped posture and balance issues. Essential tremors won’t cause associated health problems
- Essential tremors may affect a person’s voice; Parkinson’s won’t
- Parkinson’s disease has rest tremors—they are felt when the person is at rest, whereas essential tremors are typically felt when they are in motion
Essential tremor symptoms, like the symptoms of Parkinson’s disease, can get progressively worse. However, they generally won’t shorten the person’s lifespan as Parkinson’s disease will.
When do you know it’s time for help with your essential tremor?
While a benign essential tremor might be manageable in its early stages, the condition is progressive—it will tend to get worse over time.
Kensington Park Senior Living communities have the experience and passion for caring for those with a variety of conditions associated with aging.
Reach out to the Kensington Park team with any questions or for more information regarding your loved one’s caregiving.