Essential Tremor – All That You Should Know - Dr. Shivam Mittal

1. Essential Tremor – All That You Should Know – Dr. Shivam Mittal Essential tremor is a condition that affects millions of people across the globe. Essential tremor is in fact the most common movement disorder among the 20 different kinds of tremors! It usually affects the hands, legs, head, and voice. Although it isn’t a life-threatening disease, but it definitely alters the life and lifestyle of the patient. Also, it is such a difficult disorder to live with, that it affects the daily activities of the patient, and also the emotional balance of the mind. If the patient experiencing essential tremor is mentally not too strong, he may end up isolating himself, further leading to depression. Coping with essential tremor is thus not an easy task. What problems can be faced with essential tremor? Essential tremor affects both upper extremities when holding a posture or with action. It may also cause constant shaking of the head and voice. Holding the basics like a spoon, a newspaper, a smartphone, a brush, a cup, can all become difficult. It also affects how a person can write, eat, drink, or even button up his shirt. This is why patients in a profession that requires high degree of fine motor control are also left unemployed. With all these difficulties, patients slowly stop socializing with others because they start finding themselves inferior. They isolate themselves to their home

2. and family, or maybe even confine themselves to their own room, which may affect their mental health and lead to depression. How does essential tremor develop? With the harsh symptoms and outcomes that essential tremor results in, how it actually starts developing within the body, you may wonder. The condition is one that slowly progresses with time. While generally the condition begins in the late 50s or 60s, many patients may start experiencing symptoms in their 20s too. The possible reason could be genetics or hereditary, where earlier family members may also be suffering from the disorder. In the early stages, essential tremor may be very mild so as not to affect any daily activities, which is why many people may not even notice it or pay much attention to it even for decades. But, as the condition progresses, it can turn into a significant problem. What actually happens is that the brain’s ventral intermediate nucleus of the thalamus malfunctions because the other parts of the brain that are responsible for limiting the activity of this nucleus are degenerated. But, the sad part is that the exact areas of degeneration that cause essential tremor have not been identified; and this is why there is no permanent cure for this disorder. How can essential tremor be diagnosed? As we have mentioned above, generally many patients do not pay attention to the tremors until they become a hindrance to daily activities. And when they do, they’ll rush to a doctor. In such cases, it is advisable to get in touch with a movement disorder specialist, and not a general doctor or neurologist. When you approach the expert, he’ll ask for some blood tests and clinical examinations. If there is no definitive diagnosis provided through such tests, the FDA-approved non-invasive DaTscan is then carried out.

3. How can essential tremor be treated? After diagnosis, the specialist will immediately put you up for treatment to control your tremors. As we have already mentioned that there is no permanent cure for essential tremor, there are certain medications and therapies that you can be put on to control your involuntary movements, and manage your condition. Medications– Anti-seizure medications like primidone, or beta blockers like propranolol, are prescribed to block the nervous system response and reduce tremor for a certain period of time. Injections– Botox injections can be used to help control the tremors for a few months. Lifestyle changes– The doctor may advise you certain lifestyle changes that can help you drink, eat, write, and hold better. Surgery– When nothing else seems to work, a surgery is then the last alternative. The Deep Brain Stimulation surgery is an invasive surgery that can help control the involuntary movements involved with essential tremor. But, this again, is a procedure that can only manage the condition for a few months or years, and not eliminate the tremor altogether. As you can see, none of the above treatments are a permanent cure. This means that you’ll need to keep treating yourself for a lifetime! And, while you do so, you don’t want any side-effects of these long- term medications or therapies to further affect your quality of life in any other way. While we don’t promise you a side-effect-free life because every medication, every injection, and every surgery comes with its own consequences, we can advise you to only get the right treatment option that is appropriate for you. Dr. Shivam Mittal can help with diagnosing your condition, analyzing your entire health and medical history, and only then prescribing only the most appropriate tremor treatment in UAE for you.

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