Symptoms
The most common cause of tremor/shaking is so-called essential tremor, which must be clearly distinguished from Parkinson’s disease. Whereas in Parkinson’s disease the tremor is most pronounced at rest, for example when the arms are hanging down, patients with essential tremor mainly shake when they are holding something, for example when reading the newspaper or holding a cup. The commonest form is hand tremor, which almost always affects both hands; head shaking tremor or voice tremor are also common. A genetic predisposition plays a major role in this disorder, but it can skip generations within a family. Interestingly, in a large proportion of patients, consumption of even small amounts of alcohol can briefly reduce essential tremor (alcohol sensitivity). Many people affected find it particularly stressful that tremor is also socially stigmatized. They hardly dare to eat or write in public and avoid encounters with other people. It is not uncommon for people suffering from tremor to be mistaken for being very nervous or alcoholics.
Symptoms
Causes
The origin of essential tremor is not known exactly, but it is known that the cerebellum plays a role in its development. Some patients may also have a slight balance disorder, which is then associated with the disease.
What we can offer
Tremor/shaking can be a symptom of many other diseases, such as Parkinson’s disease, it can occur in metabolic disorders (e.g., hyperthyroidism), or it can be associated with rarer diseases such as dystonia. Special blood tests and MRI examination are therefore necessary.
Treatment/progression
There is no drug available today that can cure familial essential tremor, but treatment and improvement is possible in many cases. However, some patients respond well to medications. These include propranolol, a beta-blocker that is used primarily to treat high blood pressure and reaches the affected regions of the brain better than more modern beta-blockers. Another drug is primidone (an epilepsy drug), which blocks the release of excitatory substances and the propagation of nerve impulses in the brain. Other therapeutic options include gabapentin or topimarate, drugs used in epilepsy therapy.
