Basically, everyone has a certain tremor, which manifests itself in the form of a slight tremor.
However, the normal, physiological, tremor is usually not noticed because it is too weak. But there are various diseases, such as Parkinson's, that can cause increased tremors. What stands out among these types of tremor is the essential tremor, as it can be distinguished from the others by the fact that it usually goes hand in hand with no further illnesses or symptoms.
In addition, the essential tremor is the most common form of the known tremor types. In approx. 60% of the cases a genetic cause is assumed. Due to the dominant inheritance, in which one gene already leads to the onset of the disease, large parts of a family are usually affected by an essential tremor.
New studies suggest that about 60% of cases of essential tremor can be traced back to genetic causes that are associated with changes on chromosomes 2,3 and 6. The inheritance is autosomal dominant. That means there only has to be one defective gene for the disease to break out.
However, the disease can also occur spontaneously without changes in the genetic make-up being found. It is believed that neural malfunctionsuch as the lack of inhibition of certain nerves or disorders in areas of the Cerebellumlead to the typical symptoms of tremor. These malfunctions usually only develop in the course of development, which can be recognized by the fact that Children very rarely affected and the disease does not develop until the age of twenty. The course is usually progressive so that the tremors get stronger over time.
Is essential tremor inherited?
One cannot say that an essential tremor is always inherited. However, studies have shown that essential tremor also runs in the family for many people. It is assumed that about 60% of all people suffering from essential tremor are inherited from the disease. The exact mechanisms, however, are not yet fully understood. Presumably there are certain sections of the DNA that are passed on from the sick parent to the child.
To diagnose the essential tremor, a detailed medical history, a neurological examination and, if necessary, laboratory diagnostics are carried out.
A diagnosis of essential tremor is one Exclusion diagnosis. All other diseases that could lead to these symptoms are excluded by diagnostic measures, so that in the end there is a high probability that the diagnosis of the essential tremor can be made.
But there are other criteria that can be helpful in making a diagnosis. So is usually a Symmetrical tremor of the holding and action muscles on both sides ascertain. A resting tremor occurs only very rarely and would rather suggest Parkinson's disease.
In addition, the course of the disease is often progressive and long. Many patients also report relatives who also suffer from essential tremor during the conversation with their doctor. A Improvement of the symptoms with alcohol consumption is not an exact criterion, but can indicate the disease in question if in doubt.
An essential tremor is what is known as one Action tremor. That means the tremor only occurs when the person wants to take an action, such as reaching for a glass of water. There is no pronounced tremor at rest.
The frequency, i.e. how fast the trembling is, and the amplitude, i.e. how strong the trembling is, can vary greatly here.Generally speaking, the frequency decreases with age, but the amplitude increases and the involuntary movements become more extensive.
This tremor can affect different areas of the body, but it is usually symmetrical (equal sides). On the one hand, it affects the extremities, especially those hands, but also the head (Head shaking tremor) and the vocal cordsresulting in a weak and shaky voice.
These symptoms usually only start in adulthood. Most patients develop symptoms appear between the ages of 20 and 60but which are then progressive. Children are very rarely affected.
Targeted therapy for essential tremors is relatively difficult, as the exact causes have not yet been adequately researched. Some active ingredients and treatment methods have proven to be effective in recent studies.
The drug of choice is a combination of propanolol (a beta blocker) and primidone, which has an antispasmodic effect. This can lead to side effects such as dizziness, nausea and tiredness, especially with the initial setting.
Other drugs that are being considered today are arotinolol (beta blockers), clonazepam (benzodiazepine), and topiramate (anti-epileptic). If these drugs do not work or the side effects are too pronounced, surgical intervention on the brain can also bring about improvement. In the past, a so-called thalamotomy was performed for this, in which part of the thalamus was destroyed by strong heat generation. The thalamus is an essential part of the human brain and is often considered to be the 'gateway to consciousness'. Here, however, pain and movement stimuli are also processed. However, studies have now shown that high-frequency stimulation of the thalamus (using electrical impulses) leads to better results and has significantly fewer side effects over a longer period of time.
Is Essential Tremor Curable? Find out more here!
Essential tremor medication
In principle, drug therapy for essential tremors is always preferable to neurosurgical therapy, as the side effects of an intervention can be very serious. But in severe cases, such therapy is the only remaining form of therapy.
Be used for drug therapy especially beta blockers and anticonvulsants, antispasmodic drugs, used. ? -Blockers are actually used for cardiac arrhythmias, but an effect on the essential tremor was proven by chance. The reason for the effect is still unknown today.
A combination of Propanolol, the beta blocker, with a dose of 30-320 mg / day and Primidon (30-500mg / day). If this combination does not help, there are still some reserve preparations such as topiramate (400-800mg / d), Gabapentin (1800-2400mg / d) and arotinolol (10-30mg / d).
Alcohol is in no way a long-term effective and sensible therapy option.
For essential tremor, various herbal remedies can help relieve symptoms. The focus is on the calming effect on the nerves. It also reduces the hypersensitivity of the nervous system to relieve muscle tremors. This also reduces the agitation that is caused in most patients by the rapid muscle movements.
Herbal medicines include, for example, yellow jasmine. This can reduce the tremors in the hands and also has a generally calming effect. Wormwood can help relieve cramps that can result from persistent muscle movements and twitching. Fly agaric helps with the restlessness caused by the tremor. Melissa also reduces restlessness and nervousness and also has a generally calming effect on the nervous system. Valerian can also help relax and relieve cramps. Passionflower also helps with cramps and reduces the nervousness that often occurs as part of the twitching of essential tremors. Furthermore, oat straw and lady's slipper reduce the excessively pronounced sensitivity of the nervous system.
There are some remedies that can be used as part of homeopathic therapy against essential tremor. These include Agaricus muscarius, the poison of the toadstool, Antimonium tartaricum, also known as emetic tartar, and Aranin, a spider poison. Following the homeopathic principle, these substances are diluted to such an extent that they no longer develop any toxic (toxic) effects in these concentrations, but still have positive effects on the symptoms of essential tremors
Schüssler salts can be used as a possible homeopathic remedy to alleviate the symptoms of essential tremor. Especially Ferrum Phosphoricum (No. 3), Magnesium Phosphoricum (No. 7) and Lithium chloratum (No. 16) are recommended. No more than three salts should be taken at the same time. Depending on your needs, 1-3 tablets are taken three to a maximum of 6 times a day. The tablets should be taken individually and left in the mouth, where they can slowly dissolve.
Can you cure essential tremor?
A few years ago it seemed hopeless to be able to completely cure an essential tremor. With a suitable drug therapy, it was possible to delay the course of the disease or make the symptoms less pronounced. But great strides have been made in this field since then.
It is possible today to achieve permanent symptom relief, sometimes even a cure, with high-frequency stimulation of certain brain regions. This operation, in which electrodes are inserted into deep brain regions, is very safe with a complication rate of 0.3% and represents a good therapy option for people with essential tremors, in whom the drug therapy has not brought about the desired improvement.
Does alcohol affect essential tremor?
Ingesting small amounts of alcohol can sometimes cause a short-term reduction in tremor be effected. However, the tremors often worsen over the next few days and show that regular alcohol consumption is not a long-term solution for treating essential tremors. In addition, with regular consumption of alcohol, even in small amounts, there is a risk of alcohol dependence.
The essential tremor is one of the progressive diseases. This means that the symptoms often get worse as you get older.
Since one assumes mainly a hereditary cause, the disposition for the disease is already given in childhood. Here, however, it often does not appear, why is unclear. Most people will experience symptoms between the ages of 20 and 60. From here on, the symptoms of the disease will get worse over time. It is noticeable that the frequency of the tremor decreases, but the amplitude increases. In severe cases, those affected can sometimes no longer hold onto objects in such phases.
But this does not apply to all those affected. Cases are also reported in which the severity has remained the same for a long time and it does not have a strong impact on everyday life until old age. An improvement in symptoms over time is very rare, but has been described.
Essential tremor in young people
Essential tremor, like almost any other tremor, can occur in young people. It occurs most often around the age of 40. If symptoms occur earlier, such as recurring tremors in the hands or other parts of the body, an essential tremor may also be present. One then speaks of a so-called juvenile form. If a young person develops symptoms that are reminiscent of a tremor, a doctor should be consulted for clarification.
Degree of disability
It is difficult to determine the degree of disability in the presence of essential tremor, as the course of the disease differs in many people and can occur frequently or in phases. There is also a diagnosis of essential tremor no precise assessment guidelinesas is the case with Parkinson's disease, for example. This lists exactly which restrictions lead to which degree of disability.
However, the limitations described here often relate to general mobility. The essential tremor only rarely has an influence on this, but much more on active movements such as gripping a glass or writing a text. A Expert opinion from a qualified doctor is therefore all the more important when applying for a degree of disability.
Essential tremor in contrast to Parkinson's disease
For laypeople, the appearance of essential tremor and Parkinson's disease can often look the same. However, if one deals with the details of the two diseases, one recognizes serious differences in the origin, but also in the symptoms of the diseases.
So it is assumed that the Parkinson's disease by the perishing of nerve cells in a certain brain region, the Substantia nigra, because this region is an essential part of motor control.
In contrast, in the case of essential tremor, only functional disorders in the cerebellum and in the cerebral cortex (see also: Cerebrum) without being able to identify a more precise structure as the cause. In terms of symptoms, the biggest difference is that the Parkinson's disease a resting tremor causes what is not the case with essential tremor. In the latter, the tremor usually only occurs when targeted movements are to be performed. In addition, there is a difference in the course of the diseases, since Parkinson's disease can also cause psychological, vegetative and sensitive disorders over time, in addition to motor restrictions. These include depression, sexual dysfunction, temperature regulation disorders and many more. In general, it can be said that Parkinson's disease is a more severe clinical picture than essential tremor.
Additional information can be found here: Symptoms at Parkinson's disease