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 Essential tremor (ET), the most common movement disorder, is a progressive, often inheritable disorder usually beginning before the age of 50. It is characterized by tremors when the arms are held out in front (pointing) and when they are being used (eating or drinking). The tremors may also affect the head, voice, tongue and legs. The tremor is invariably worsened with stress, fatigue, and stimulant medications. Although many features of ET differ from the tremor of Parkinson's Disease, the two are often confused. The formal diagnosis of ET is made 5 or more years from onset, if the patient has not developed other symptoms of Parkinson's disease. What Causes ET? ET is thought to be due to oscillations of brain cell activity involving a part of the brain called the inferior olive which projects to the muscles via cerebellum, thalamus, and cortex. Interruption of tremor signals along this pathway may be the basis for the effectiveness of thalamic (ventral intermediate thalamus - Vim) stimulation in the treatment of essential tremor. Treating Essential Tremor Patients with significant functional impairment often 
opt for treatment. For some patients, the tremor may not be functionally disabling, but instead may 
be a source of severe embarrassment causingsocial isolation so that they also opt for treatment. 
The decision to treat with medications is made when the degree of impairment or discomfort outweighs the side effects of treatment. When patients do not achieve satisfactory control of their tremor with non-medical or medical therapies, and there is significant functional impairment, surgical options should be considered. (Follow the links above on the right for details about treatment options.) |
