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What Is The Difference Between Parkinson’s Disease And Essential Tremors

How Is Parkinsons Disease Treated

What is the difference between Essential tremor and Parkinson Disease tremor?

The treatment protocol varies along with the stage of Parkinsons disease the patient is undergoing-

Medicines: In the initial stages medication may be provided to ease out the symptoms experienced by the patient.

Occupational Therapy: As the stage progresses, occupational therapy may be required. This may help the patient reduce the stiffness of the muscles. The occupational therapy helps with both the fine and gross motor abilities of the patient.

Mechanical Help: Walkers and wheelchairs may become essential, as the patient gradually becomes unable to even walk or stand alone.

Personal Caregiver: It may become very difficult for a patient with Parkinsons disease to live alone as the stage progresses. Thus a caregivers assistance is equally important along with the medication.

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How Can I Better Cope With Having Parkinson’s Disease

The most important step you can take is to seek help as soon as you feel less able to cope with Parkinson’s disease. Taking action early will enable you to understand and deal with the many effects of your condition. A mental health care provider can design a treatment plan to meet your specific needs. Strategies can be designed to help you regain a sense of control over your life and improve your quality of life.

Other steps you can take include the following.

  • Find out as much as you can about the illness.
  • Talk to your friends and family about it. Don’t isolate them. They will want to be involved in helping you.
  • Do things you enjoy.
  • Do not be afraid to ask your doctor, nurse, or other health care provider to repeat any instructions or medical terms that you don’t understand or remember. They should always be available to answer your questions and address your concerns.
  • Make use of resources and support services offered by your hospital and in your community.
  • Learn to manage stress. This will help you to maintain a positive physical, emotional, and spiritual outlook on life. Being stressed out will only make the situation worse. You should try to organize a daily routine that will reduce stress, with down time for both you and your family members.
  • If you are depressed — and this is more than just feeling sad occasionally — antidepressants can be prescribed to help lift your mood.

Parkinsons Disease And Tremors

Parkinsons disease is a chronic, degenerative disorder which results from the malfunction and/or loss of brain cells responsible for movement and coordination. Key symptoms include tremor, rigidity, slow movement and postural instability.

In an estimated up to 26% of PD patients, the primary symptom is tremor2. These patients initially have tremor and as the disease progresses, they may experience other symptoms. There are patients who report that tremor remains the symptom with the most severe impact on their daily activities.3

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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.

Causes: Parkinsons Vs Essential Tremor

Differences between Parkinsonian tremor and essential ...

The cause is largely unknown for both Parkinsons and essential tremor. However, there are theories about what may cause these conditions.

In regards to essential tremor, John Hopkins Medicine notes that there is a theory that the condition may be caused by miscommunication between the cerebellum and other parts of the brain. There is also believed to be a genetic predisposition for developing essential tremor. You may be 50% more likely to develop essential tremor if your parent has the condition.

It is also important to note that certain factors can also cause other types of tremors. For example, according to the National Institute of Neurological Disorders and Stroke, certain medications, thyroid overactivity, and toxins like lead and mercury can produce tremors that might be confused with this condition.

In regards to what causes Parkinsons disease, the direct cause as to why specific individuals develop Parkinsons is unknown. However, what happens within the body that causes Parkinsons symptoms to manifest, is the gradual loss of brain cells that are responsible for producing dopamine. When this happens, it can interfere with normal body movement, leading to patients to exhibit the common symptoms of Parkinsons.

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Treatments For Essential Tremor

According to Harvard.edu, there are several actions that can be taken to help manage your essential tremor and minimize how they impact your daily life. First, lets cover treatment options:

  • Oral Medications: Propranolol and primidone are considered to be the most effective treatments for essential tremor, reducing tremors as much as 50%. Propranolol is a beta-blocker and primidone is an anti-seizure medication.
  • Surgical Treatment: In cases where essential tremor does not respond to medication, surgery may be recommended. There are invasive techniques, such as deep brain stimulation, that can be used to help reduce tremors. However, brain surgery is not without its serious risks.
  • Non-Invasive Therapy with Cala Trio: Cala Trio is a wrist-worn non-invasive therapy device that is calibrated to relieve hand tremors. It works by delivering surface stimulation at your wrist, which is believed to disrupt the central tremor network in your brain. In one clinical study, 64% of patients reported tremor relief and the average reported time was 94 minutes. Available only by prescription, the Cala Trio wrist-worn device provides on-demand tremor relief.
  • As each patient is different, you and your doctor will need to decide what the best course of action is for you. You must weigh the pros and cons of each treatment option based on your lifestyle and how you think theyll impact your quality of life.

    Symptoms Of Parkinsons Disease

    Knowing the early warning signs of Parkinsons disease is very important for your health. Non-motor and motor symptoms can vary slightly from case to case in PD patients. Early signs and symptoms of Parkinsons disease may be too mild to notice or may be mistaken for other similar conditions.

    As mentioned, tremors are typically the most common symptom in all Parkinsons patients. Action tremor is characterized by involuntary shaking that usually begins in the limbs, like your hand shaking even when you are at rest. They may manifest as pill-rolling tremors, wherein you rub your thumb and index finger together.

    Slow movement, medically known as bradykinesia, is another common symptom of Parkinsons disease. As the disease progresses, all of your movements may get slower and slower, making everyday tasks difficult or more time-consuming. What are some motor symptoms? You may have trouble walking or lifting yourself out of chairs. Your feet may drag or feel like they are stuck to the floor, and your steps may get shorter.

    Your limbs may also become rigid. Muscle rigidity and stiffness can be painful and reduce your full range of motion. Furthermore, your posture may begin to deteriorate, resulting in you stooping, slouching, postural instability, or hunching over even when you think you are standing straight. Performing coordination exercises for Parkinsons patients may be beneficial for their physical health.

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    Can Et And Pd Occur Together

    Even more frightening is when PD or other parkinsonism syndrome occurs along with ET. Parkinsonism refers to conditions that resemble PD in many ways but are not true PD. A big difference is that medications that work for PD, such as L-dopa, have little or no effect on parkinsonism. In addition, a person with parkinsonism may not have tremors but will have other similar PD symptoms: bradykinesia , stooped posture, stiff walking, small steps, and reduced arm swinging when walking. Treatment using Deep Brain Stimulation does not help with parkinsonism.

    There are other variants that are considered atypical Parkinsons disease . There is also a very rare condition called Progressive Supranuclear Palsy . In its early stages it also looks like PD or one of the forms of parkinsonism but with ongoing degeneration, stiffness, dizziness and falls become worse. There can also be personality and cognitive changes. Since any of the above can co-occur with ET, gaining an accurate diagnosis of co-existing conditions can be a confusing process. Symptoms overlap, so trying to tease out one diagnosis from another is challenging.

    S Of The Body Affected

    Differences Between Essential Tremor and Parkinson’s Disease

    The tremor in PD usually starts on one side of the body and may develop on the other side as the disease progresses. In ET, the tremor usually affects both sides from the beginning of the condition.2

    The hands are more often affected with tremor than the legs in people with PD, and the voice and head are almost never involved. In ET, the hands are also predominantly affected, but the tremor can also be present in the head and voice.2,3

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    What Resolves Your Tremor

    The tremors seen in Parkinson’s disease almost always get better when they start using the medication levodopa along with their other motor symptoms, like slowness of movement and rigidity. The same medication doesn’t work well for people with Essential Tremor, who instead benefit from treatment with primidone and propranolol. Essential Tremor patients may also notice that drinking alcohol stops or reduces their tremor, which is not the case in those who have Parkinson’s disease.

    How Is Parkinsonian Tremor Diagnosed

    Doctors often diagnose tremors through physical and neurological examinations and a medical history review. During the physical evaluation, a doctor will assess the tremor to see if it occurs when your muscles are at rest or in action, where they are located on your body, if they occur on one or both sides, and their frequency and amplitude. They will also assess other neurological functions such as walking, balance, speech, muscle tone, and mobility.

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    What Is The Difference Between Essential Tremor And Parkinsons Disease

    Essential tremor is a neurological disease with autosomal dominant inheritance, which is characterized by the development of bilateral, low amplitude tremor prominently seen in the upper limbs. On the other hand, Parkinsons disease is a movement disorder characterized by a decline in the dopamine level of the brain.

    Furthermore, essential tremors can affect patients of any age, but the peak incidence is in the early decades of life. However, Parkinsons usually occurs in the elderly people. Moreover, essential tremors have an autosomal dominant trait while Parkinsons disease is not known to have a genetic trait. The below infographic presents more details on the difference between essential tremors and Parkinsons disease.

    What Is The Difference Between Essential Tremors And Parkinson’s Related Tremors

    10 SYMPTOMS THAT DISTINGUISH BETWEEN TREMOR FROM ESSENTIAL ...

    Essential tremor is a condition that causes uncontrollable shaking in different parts of the body, including the arms, hands, voice box , tongue, and chin. While an essential tremor often affect the voice and head, head tremors are uncommon in Parkinsons. Additionally, essential tremor tends to worsen when a part of the body is in motion, while Parkinsons-related tremors decrease when the body is in motion.

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    Et And Pd In Family Members

    Several studies have examined ET and PD within large multigenerational families. In one large family with a mixed history of ET and PD, 11 family members had limb/head tremor that presented early of life. Three brothers in the family went on to develop PD in their 50s, and on autopsy showed cell loss in the substantia nigra and Lewy body formation characteristic of PD. Another study of a multigenerational family provided data on 138 individuals including 65 that were examined, 11 of whom were noted to have PD including six with likely coexistent ET and PD, and an additional 19 individuals with ET. The presence of multiple cases of both ET and PD in these families argues strongly for a genetic component, while the coexistence of both conditions within each family favor the concept of phenotypic variation of a common gene rather than two separate genetic conditions.

    Signs & Symptoms: Is It Essential Tremor Or Parkinsons

    In order to start managing your condition and receive the treatment you need, you should be aware of the most common signs and symptoms as well as the key differences between essential tremor andParkinsons. After all, the first step in getting care as early on as possible is self-awareness that you might be suffering from one of these conditions.

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    Defining The Condition: Parkinsons Vs Essential Tremor

    What is the difference between Parkinson√Ęs disease and other tremors? (Karen Blindauer, MD)

    Parkinsons Disease: According to the Parkinsons Foundation, Parkinsons disease is a neurodegenerative disorder that affects predominantly dopamine-producing neurons in a specific area of the brain called substantia nigra. Parkinsons itself is not a fatal disease, however, it can have serious complications that can be.

    • At what age does Parkinsons usually manifest? Typically Parkinsons typically manifests in individuals 50 years or older. However, Young Onset Parkinsons , affects 2% to 10% of individuals in the U.S. with Parkinsons.
    • What is the prevalence of Parkinsons disease? According to Nih.gov, approximately 1.8% of adults 65 and older suffer from Parkinsons disease.

    Essential Tremor: As defined by John Hopkins Medicine, essential tremor disorder is a neurological condition that causes your hands, head, trunk, voice, or legs to shake rhythmically. Generally, these tremors are worse when moving than when at rest. However, tremors can be severe enough to interfere with regular daily activities such as eating, speaking, and even using the restroom independently. Essential tremor is considered benign, or non-life-threatening.

    • At what age does essential tremor usually manifest? Essential tremor typically affects individuals over the age of 65, however, it can develop at any age.
    • What is the prevalence of essential tremor? According to Nih.gov, approximately 4.67% of adults 65 and older suffer from essential tremor.

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    What Are The Symptoms

    Symptoms of essential tremor vary from person to person, as does the rate of progression.

    • Rhythmic tremors of the hands, legs, or trunk
    • Head nodding in a “no-no” or “yes-yes” motion
    • Voice quivering
    • Tremors that occur involuntarily and cannot be stopped.
    • Tremors that get worse during periods of stress and that lessen during rest.
    • In rare cases, mild gait disturbance.

    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

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    What You Need To Know

    • Essential tremor disorder is a neurological condition that causes your hands to shake rhythmically. The head, trunk and voice might also be involved, but hand shaking is most prominent. The cause is not known, but it is often passed down from a parent to a child.
    • Essential tremor is sometimes confused with other types of tremor, so getting the right diagnosis is important.
    • Tremors tend to be worse during movement than when at rest. The tremors can be disabling and can slowly worsen over time.
    • Some things might make tremors worse, and avoiding them may be helpful. Medicines can also help control or limit tremors in some people. Severe tremors can sometimes be treated with surgery.

    Handwriting: A Strange Clue

    Parkinson

    Micrographia, very small and crowded handwriting, is one of the hallmark signs of Parkinson’s disease that doctors will look for it’s even one of the main reasons they’ll ask patients to fill diagnostic questionnaires out themselves. This handwriting may start off having a normal “font size”, but then gradually become smaller and smaller as the patient writes more.

    People with Essential Tremor don’t have micrographia their handwriting can be affected by their condition, but it’s much more likely to become larger and more shaky .

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    How Is Dyskinesia Diagnosed

    Parkinsons dyskinesia is most often diagnosed via a physical examination and clinical history review. Movement disorder specialists and neurologists are best equipped to make this diagnosis. To help confirm the diagnosis more objectively, your doctor may also suggest that you video yourself when youre at home or use a wearable device that can detect movements over time.

    Changes In Volume Of Brain Areas For Et Patients As Compared To Normal Subjects

    This portion of the study draws attention to the volumetric changes in the brains of ET patients compared to age-matched normal subjects. These two VBM methods consistently found that the brain volumes of the ET group were significantly smaller in many brain regions than that of control group, including the caudate body, the middle temporal pole , the IN, the precuneus , and the superior temporal gyrus . The detailed brain atrophy for the ET group is listed in Table S3A in Supplementary Material . These two VBM methods, however, persistently identified the gray matter of the middle temporal gyrus , and the precentral gyrus in the ET group, to be larger than that of the normal control group . The same color row marked similar brain regions for both methods. The contrast maps between the two groups are shown in Figure 3.

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