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Medically Reviewed by: Dr. BautistaUpdated on: September 9, 2021
Parkinsons disease is one of the most common and well-known neurodegenerative disorders in the world. Worldwide, estimates suggest that over 10 million people currently live with Parkinsons disease. In America alone, there are about 60,000 new Parkinsons diagnoses every year.
One of the main and most characteristic symptoms of Parkinsons disease is a tremor or involuntary shaking. However, Parkinsons disease is by no means the only condition that causes a tremor. Essential tremors are also noted by shaking. Learn more about the difference between essential tremor and Parkinsons disease below.
What Is The Difference Between Essential Tremor Andparkinson’s
The exact cause of essential tremor is unknown while Parkinson’sdisease is better understood.
In Parkinson’s disease, neurons located in the part of the brain thatcontrols movement become impaired or die. These neurons usually produce achemical called dopamine which enables regular body movements. When the neuronscan’t produce necessary levels of dopamine, tremors can occur, along withrigidity of limbs and decreased coordination.
Sleep Well And Relax To Avoid Stress
Speaking of how to stop tremors, take good care of yourself! Anxiety and fear are a common cause of tremors. Therefore, make sure you relax to remove life tension and stress. Relaxation can be realized through yoga, breathing and meditation which can benefit your nervous system greatly. These should be accompanied with enough sleep.
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Controversy About The Relationship Between Et And Parkinsonism
There is no doubt that some people with ET go on to eventually develop PD or other parkinsonism syndrome. Since there continue to be unresolved questions about the link between the two disorders including lack of verifiable diagnostic criteria for the two disorders and marked overlap in phenomenology,ii why this occurs and what the specific brain abnormalities might be is not understood. Reports in the literature identify such features as
- Overlapping motor and cognitive symptoms
- Rapid eye movement sleep behavior disorder in 26-43% of those with ET
- Prevalence of those with longstanding ET later being diagnosed with PD
- Greater prevalence of ET in family members of PD patients
- The presence of Lewy bodies in the brains of 15-24% of people with ET.iii
Parkinson’s Disease Vs Essential Tremor Early Symptoms How They Differ
As many as one million Americans currently live with Parkinson’s disease and approximately 60,000 Americans are diagnosed each year. Around the world, more than 10 million people worldwide are living with the disease, according to the Parkinsons Disease Foundation.
A new study published in the journal Brain has shed new light on the genetics behind essential tremor, which is frequently misdiagnosed as Parkinson’s disease. Understanding the differences between both diseases is key to reducing the prevalence of medical mistakes. Heres everything you need to know about both diseases.
Researchers are examining the genetics behind how essential tremor affects the body.Photo courtesy of Simon Gerard
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Next Steps: Getting Care For Parkinsons And Essential Tremor
If you believe you have Parkinsons disease or essential tremor, dont hesitate to seek professional care. Your doctor can help you diagnose your condition, find the right treatment plan for you, and manage your symptoms so you can enjoy the best quality of life possible. While suffering from a condition like essential tremor or Parkinsons can be frightening, you dont have to face it on your own.
Stay in touch!
Who Is Affected By Tremor
About 70% of people with Parkinsons experience a tremor at some point in the disease. Tremor appears to be slightly less common in younger people with PD, though it is still one of the most troublesome symptoms. People with resting tremor usually have a more slowly progressing course of illness than people without tremor.
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How To Stop Tremors With Medical Treatments
Treating the condition causing tremors may be sufficient to address it. All the same, the tremor can be treated using medications. Some of the common medications for tremors are listed below:
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Beta-blockers are prescribed for people with high blood pressure conditions and also useful in reducing tremors for certain individuals.
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Tranquilizers like Xanax could be given to relieve tremors as a result of anxiety.
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Anti-seizure medication is usually provided as an alternative for people who cannot use beta-blockers.
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Botox injections are chemical injections that are usually given to individuals suffering from tremors affecting the head and face.
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Physical therapy may be done to help people strengthen their muscles and enhance their body coordination. Wrist weights along with adaptive devices like heavier utensils can also help in treating tremors.
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Brain stimulation involves a surgery that could be the only choice for people with debilitating tremors. In such an operation, the surgeon puts an electrical probe in a part of your brain in control of the tremors. After the placement of the probe, a wire is connected from the probe into the chest, below the skin. A small device is then placed on the chest and is connected to the wire to send pulses directly to the prop to stop the production of the tremors.
Find Out If Big Therapy And Exercise Can Help You Or A Loved One
CoxHealth Rehabilitation Services and CoxHealth at Home offer LSVT BIG therapy, an exercise routine for people with Parkinsons disease. LSVT BIG therapy uses high intensity, focused exercises to improve movement, strength and flexibility. For more information, call 417-269-3616.
Parkinsons exercise classes are offered at The Meyer Center. Call 417-269-3282 for more information.
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What Are The Results
Successful DBS is related to 1) appropriate patient selection, 2) appropriate selection of the brain area for stimulation, 3) precise positioning of the electrode during surgery, and 4) experienced programming and medication management. DBS for essential tremor may significantly reduce hand tremor in 60% to 90% of patients and may improve head and voice tremor.
Patients report other benefits of DBS. For example, better sleep, more involvement in physical activity, and improved quality of life.
What Causes Essential Tremor
The cause of essential tremor is unknown. However, one theory suggests that your cerebellum and other parts of your brain are not communicating correctly. The cerebellum controls muscle coordination.
In most people, the condition seems to be passed down from a parent to a child. If your parent has ET, there is a 50% chance you or your children will inherit the gene responsible for the condition. Sometimes, ancillary testing such as brain imaging or genetic testing may help with the diagnosis.
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Essential Tremor Is Not Parkinsons Disease
Essential tremor and Parkinsons disease are different conditions. Essential tremor is characterised by shaking when movement starts, which can continue or worsen during movement. The symptoms of Parkinsons disease include:
- involuntary tremor when you are not moving
- muscle stiffness
- slowness of movement
- freezing.
Parkinsons disease is caused by a lack of supply of the brain chemical dopamine, which is necessary for smooth and controlled muscular movement.
Take In Sufficient Minerals
Minerals are very useful in the transmission of nerve impulses to muscles. A depletion of electrolytes will certainly cause tremors. The lack of enough magnesium leads to convulsion and muscle spasms which in turn may lead to tremors.
Potassium is useful in controlling muscle and nerve cell activities hence its deficiency results in tremors. Calcium is mainly important for your teeth and bones and some part of it in blood that makes muscles contract well, enhance blood clotting and enhance the transmission of messages by nerves around the body. Calcium deficiency can cause regular tremors.
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Tremor In Other Conditions
While tremor is a common symptom of Parkinsons, it can also be a symptom of other conditions, most notably essential tremor. The main difference between Parkinsons tremor and most other types of tremor is that in Parkinsons resting tremor is most common. Other conditions are usually characterized by action tremor, which tends to lessen at rest and increase when youre doing something, like trying to make a phone call or take a drink.
Tremors of the head and voice are also common in essential tremor but rare in Parkinsons.
What Is Essential Tremor
Essential tremor is a neurological disorder that causes your hands, head, trunk, voice or legs to shake rhythmically. It is often confused with Parkinson’s disease.
Essential tremor is the most common trembling disorder. Everyone has at least a small degree of tremor, but the movements usually cannot be seen or felt because the tremor is so small. When tremors are noticeable, the condition is classified as essential tremor.
Essential tremor is most common among people older than 65, but it can affect people at any age. Some experts have proposed considering ET that starts earlier in life as essential tremor and ET that begins later in life as age-related tremor, because the conditions may have different symptoms and may respond differently to treatments.
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Recommendation For Those With Et
ET, PD and parkinsonism have one thing in common: they dont affect individuals in identical ways. There are accepted diagnostic guidelines, but an infinite number of small or large differences can occur: rate of progression, response to medication, nature of lifestyle problems and impairment, etc. If two persons with ET were to compare notes, they would quickly find that things like propranolol helps one but not the other, or one of them gets terrible restless leg syndrome at night while the other has never had it, etc. Thus, there is a growing theory that ET is not a single disorder, but a group of disorders.
For those with ET who notice that they have additional symptoms that dont fit the classic ET descriptions in books or websites, we recommend discussing the situation with a movement disorder specialist. Perhaps theres no cause for concern, but it may be worth seeking an evaluation to rule out a co-occurring form of parkinsonism. Accurate information may be your best friend, since it both equips you and your doctor to strategize treatment, and also to manage anxiety and gain peace of mind.
iRajput AH, Rajput EF, Bocking SM, Auer RN, Rajput A. Parkinsonism in essential tremor cases: A clinicopathological study. Mov Disord. 2019 Jun 10. https://www.ncbi.nlm.nih.gov/pubmed/31180613iiTarakad A, Jankovic J. Essential tremor and Parkinsons disease: exploring the relationship. Tremor Other Hyperkinet Mov. 2018 8:589.iiiIbid.
Getting Treatment: Essential Tremor Vs Parkinsons Disease
There is currently no cure for essential tremor or Parkinsons. However, that does not mean you have no control over your condition. As doctors learn more about these conditions, developments in treatment and disease management continue to help patients preserve their quality of life as much as possible.
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Medications For Essential Tremor
Propanolol and primidone are two of the medicines often prescribed to treat essential tremor.
Propanolol blocks the stimulating action of neurotransmitters to calm your trembling. This beta blocker is effective in 40% to 50% of patients and is less useful in reducing head and voice tremor. It is usually avoided in patients with asthma, emphysema, congestive heart failure or heart block, and should be used with caution by people with diabetes who are on insulin. These drugs may reduce exercise tolerance, lower blood pressure or heart rate, exacerbate depression and cause impotence. Other adrenergic blockers with fewer side effects include atenolol, nadolol, metoprolol and timolol.
Primidone controls the actions of neurotransmitters. Some patients starting primidone may experience a first dose phenomenon during which they have transient feelings of unsteadiness, dizziness and nausea during the beginning stages of treatment. This is usually short-lived. Sedation is another common side effect and can be reduced by following a slowly escalating dose schedule. Most patients are able to tolerate the side effects, and studies have shown that 60% to 100% of patients respond positively.
If primidone or propranolol are not effective by themselves, a combination of both may provide relief for some patients.
Other Tremors And How It Differs
A Parkinsonian tremor has a few distinct characteristics, though it may be easy to confuse with other types of tremors depending on the other symptoms a person shows. Doctors will look for and rule out other types of tremors to confirm their diagnosis.
The National Institute of Neurological Disorders and Stroke notes that some common tremors include:
Dopamine is an important neurotransmitter that plays a critical role in a number of bodily functions, such as movement and coordination. People with Parkinsons disease produce less dopamine, which may cause them to experience movement-related problems, such as rigidity, slowness of movement, poor balance, and tremors.
Low levels of dopamine may disrupt the way the brain processes movement, which can result in movement problems. Evidence suggests that many people with Parkinsons disease lose 6080% of dopamine-producing cells in the brain by the time they present symptoms.
Other causes of tremors unrelated to Parkinsons disease can include:
- certain medications
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What Essential Tremors Could Be A Sign Of With Joon Faii Ong
Flat vector illustration of a tremor. Trembling in the hands-symptoms of various mental disorders, panic, fear, Parkinsons disease. Isolated design on a white background.
Dr. Joon Faii Ong is a recognized expert on Essential Tremors. He explained that many forms of Tremors could affect people with Parkinsons Disease or Essential Tremors, which is Dr. Ongs area of expertise. Essential Tremors can also affect people with Parkinsons Disease or those who have had a stroke or some type of brain injury, such as traumatic brain injury .
Essential tremor is the most common movement disorder, and it affects approximately 10 percent of persons over age 65. This type of tremor has no other symptoms than trembling or shaking. Therefore, it is sometimes simply referred to as a benign tremor. There are many forms of Essential Tremors, but they all share these three key features:
- Involuntary shaking of the hands when they are at rest.
- Tremors increase with action, such as moving the arms or holding a cup.
- Tremor intensity decreases when the hand grips an object tightly.
Essential Tremors can be an indicator of several other conditions that can affect the brain or other parts of the body, including:
Diagnosing Parkinsons Vs Essential Tremor
The difference between essential tremor and Parkinsons can be so slight that it can be difficult for doctors to diagnose these conditions correctly. In fact, they are often mistaken for one another, which can be frustrating for physicians and patients alike. Specialty physicians that diagnose and treat these conditions are Movement Disorder Neurologists.
While there are no official tests for either condition, there are several diagnostic techniques that physicians employ to attempt properly diagnose essential tremor vs. Parkinsons, including:
- Physical examination: During a physical examination, a physician evaluates the patients motor skills to help in their determination of whether they suffer from essential tremor vs. Parkinsons.
- DaTscan: During a DaTscan, a radioactive tracer is injected, which makes its way into the brain, where it attaches to dopamine transporters. Special imaging scans are then conducted to see whether the dopamine system is healthy. If it is irregular, it may help diagnose your condition as Parkinsons.
- Handwriting sample evaluation: A doctor may be able to differentiate Parkinsons vs. essential tremor using a handwriting sample because those with Parkinsons typically exhibit exceptionally small handwriting, whereas those with ET exhibit larger, shaky handwriting.
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Causes Of Essential Tremor
The exact cause of essential tremor is unknown, but essential tremors tend to occur when there are nerve-related problems that influence the muscles with which they are connected. Research has also indicated that the part of the brain that controls the movement of muscles may not function properly in patients with essential tremor. In some cases, several family members may have essential tremor, known as familiar tremor and it is believed to be caused by a genetic mutation.
Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
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Alcohol In Essential Tremor And Parkinsons Disease
Alcohol drinks contain the substance ethanol, which is a psychoactive drug. Alcohol in low doses may cause euphoria, reduced anxiety, and sociability, while in high doses it may cause drunkenness , stupor and unconsciousness. Long term use may lead to alcohol dependency. While alcohol may cause all these, it affects Parkinsons Disease and Essential Tremor patients differently. Tremoring may occur due to many different diseases and reasons. Alcohol withdrawal and abuse can cause said tremors, especially in the hand, since alcohol kills certain nerve cells. For Essential Tremor patients the ingestion of alcohol has been shown to improve the tremors. Doctors may use alcohol to see diagnose ET if they see a decrease in the amplitude of tremors, albeit not very common. There are studies underway regarding the correlation between alcohol and ET. One of the studies conducted by JH Growdon, took 5 ET patients which showed a decrease in tremor amplitude after 15 minutes of ingesting alcohol. The same 5 patients were given equal amounts of ethyl alcohol infused into a brachial artery, and there was no decrease in tremor amplitude. Concluding that in patients with essential tremor, ethanol acts on sensitive structures within the central nervous system and has no effect on peripheral tremor-genic mechanisms. Providing evidence for a central mechanism in essential tremor, distinguishing it from other tremors arising primarily from oscillation in peripheral servo-loops.