Many people have the misconception that having shaking hands is just another part of getting older. Others are sure it’s the first sign of Parkinson’s disease.
Reality is that both of those groups are probably wrong. What could be going on is a nerve disorder known as essential tremor. While it’s not a life-threatening condition, essential tremor can become severe enough to make it basically a disability.
At Texas Neurosurgery, our three neurosurgeons can diagnose and treat essential tremor, enabling you to live a normal life despite the disorder.
What is essential tremor?
Essential tremor (ET) involves involuntary, uncontrollable shaking in different parts and on different sides of the body. Areas affected often include the hands, arms, head, larynx (voice box), tongue, and chin. ET rarely affects the lower body. Most people can still function with ET, but everyday activities such as eating, dressing, or writing can be very difficult.
What causes essential tremor?
As with some other neurological disorders, the definitive cause of ET is not fully understood. Because ET involves muscle activity, it is thought abnormal electrical brain activity that causes the tremors is processed through the thalamus. The thalamus is a part of the brain that coordinates and controls muscle activity.
There is a definite genetic aspect to ET. It is estimated that half of those with the disorder have inherited it from a parent. Some of those, however, will have the gene that is responsible for ET but will never actually experience any symptoms. Some people think ET is a natural part of the aging process, but it isn’t. Symptoms simply become more pronounced with the weakening of some muscles with age.
In the U.S., it is estimated that 10 million people have ET. It can occur at any age but is most typical to show itself for the first time in adolescence or in middle age (between the ages 40 and 50).
What are the symptoms of essential tremor?
The main symptom of ET is uncontrollable shaking, which isn’t a symptom unique to ET. Other diseases and factors can cause similar tremors: Parkinson’s disease, multiple sclerosis, brain tumors, some prescription drugs, and alcohol or drug withdrawal, among others.
These are the symptoms of ET:
- Uncontrollable shaking for brief periods
- Shaking voice
- Tremors that worsen with emotional stress
- Nodding head
- Tremors that worsen with purposeful movement
- Tremors that lessen with rest
- Balance problems (rare)
Mild shaking with this disorder doesn’t require treatment. But if the disorder impinges on your ability to function, or if you find it socially embarrassing, we have various treatment options to lessen your symptoms.
- Medications — Various medications can significantly reduce the severity of your tremors. These include Inderal, Mysoline, Neurontin, and Topamax. Other options include Xanax, Klonopin, and Valium. Botox injections can be effective for vocal cord and head tremors.
- DBS Surgery — We use Deep Brain Stimulation (DBS) for patients with severe tremors that don’t respond to medication. In DBS, electrical leads are implanted in the thalamus. The implanted electrode uses voltage to stimulate areas of the thalamus responsible for the tremors. Once implanted, a series of feedback sessions are necessary to properly program the brain stimulator.
- Surgical Lesion — We can also place a surgical lesion in the ventral intermediate thalamus. This procedure has satisfactory results in 80 to 90 percent of patients.