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Benign essential tremor syndrome

Essential tremor is a neurological disorder characterized by shaking of hands (and sometimes other parts of the body including the head), evoked by intentional movements. The incidence is unknown, but is estimated to be as common as one person in 20, and it is the most common type of tremor and also the most commonly observed movement disorder. more...

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Cause

The cause of the disease is unknown (idiopathic). While no identifiable and consistent structural abnormality has been demonstrated yet to exist in the nervous system of every person with ET, prominent researchers including Elan D. Louis are searching actively for neurochemical and brain structure abnormalities that might be commonplace among people with ET. Usually the diagnosis is established on clinical grounds, but when suspicion exists, other potential sources of tremor (excessive caffeine consumption, recreational drug use, hyperthyroidism) should be excluded. Tremor intensity can worsen in response to fatigue, strong emotions, hunger, cold, or other factors and can be reduced with alcohol in approximately 50 percent of patients. However, an over-reliance on alcohol to control tremor symptoms can sometimes lead to alcohol addiction.

There is ongoing controversy as to whether ET is related to Parkinson's disease and whether essential tremor should properly be considered a kind of parkinsonism. While some research findings appear to suggest that ET patients face a greater than average chance of developing Parkinson's, those findings might be a misleading effect of the widespread difficulty that doctors experience when they try to distinguish Parkinson's symptoms from ET symptoms and arrive at a definitive diagnosis.

Members of a family known as the "Iowa Kindred" develop either parkinsonism or symptoms that are indistinguishable from ET; their pattern of inheritance is associated with PARK4.

Diagnosis

Essential tremor is often found in more than one member of a family (familial tremor), in which case it is usually dominant in inheritance, or it may occur with no family history. Tremors can start as any age, from birth through advanced ages (senile tremor). Any voluntary muscle in the body may be affected, though it's most commonly seen in the hands and arms and slightly less commonly in the neck (causing the patient's head to shake), eyelids, larynx, tongue, trunk, and legs. A resting tremor of the hands is sometimes present, despite the common misunderstanding that a resting tremor is proof of Parkinson's Disease. ET is usually painless, although in some cases tremor of the head or neck causes pain, and writing can become painful quickly for a person with hand tremors who grips a pen tightly in a struggle to maintain control over penmanship.

ET does sometimes occur in combination with other neurological disorders such as dystonia and benign fasciculation syndrome. However, there is no clear evidence that having ET predisposes a person to one of these diseases. Conflicting research results have so far made it difficult for medical researchers to say with certainty that people with ET are more likely than the general population to experience hearing loss and a reduction or complete loss of olfaction, among a wide assortment of other non-tremor symptoms, but credible researchers have published findings to support such claims of progressive hearing loss and progressive loss of olfaction. Other published research suggests that an impaired sense of balance prevents ET patients from walking normally. It is commonly assumed among researchers that tremors are not the only symptom of ET.

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October Marks First-Ever Movement Disorders Awareness Month, Bringing Much-Needed Attention to Conditions That Affect More Than 40 Million Americans
From PR Newswire, 10/5/05

New Interactive Exhibit, the Movement Disorders Experience Center, to be Unveiled in New York City

NEW YORK, Oct. 5 /PRNewswire/ -- WE MOVE(TM) (Worldwide Education and Awareness of Movement Disorders) is proud to announce that October 2005 has been declared, by resolution of the U.S. Congress, as Movement Disorders Awareness Month. The annual designation is intended to help focus attention on movement disorders -- which are chronic and often debilitating conditions that affect more than 40 million Americans -- and highlight the importance of accurate diagnosis and treatment.

The resolution, introduced by Congressman Danny Davis (D-IL), is a significant milestone that builds on the momentum of recent efforts by many professional and patient advocacy organizations to raise public awareness about movement disorders, including the personal, financial and societal impact of these conditions, and what can be done to better manage them. This year, an unprecedented 51 professional and patient advocacy groups supported WE MOVE's Life in Motion initiative -- a campaign to raise awareness about the more than 30 neurological conditions that may be classified as movement disorders and to encourage patients to seek earlier diagnosis and treatment.

"Many patients with movement disorders find it extremely difficult to obtain an accurate diagnosis and live with significant disability for years before they receive effective treatment," said Congressman Davis. "In fact, according to statistics, a patient with a movement disorder may visit more than 15 doctors over the course of five years before receiving an accurate diagnosis. My hope is that Movement Disorders Awareness Month will help focus attention on what physicians, patients and their families can do to better manage these conditions and greatly improve the quality of life of millions of Americans."

Interactive Exhibit to be Unveiled

To commemorate this year's first-ever Movement Disorders Awareness Month, the Life in Motion initiative is unveiling a new interactive exhibit, the Movement Disorders Experience Center, in New York City at the Phillips Ambulatory Care Center, Beth Israel Medical Center on Friday, October 7th, from 10:00 AM - 11:00 AM, and at Union Square Park, on Saturday, October 8th from 10:00 AM - 1:00 PM. Other experience centers will be exhibited throughout the country over the next year and into 2006 via programs planned by Life in Motion coalition members.

The Experience Center is designed to help people understand movement disorders and their impact by enabling them to experience selected symptoms first-hand. The exhibit, free and open to the public, will feature a variety of conditions, including dystonia, Parkinson's disease, tremor, spasticity and restless legs syndrome.

Actress Geri Jewell, a national spokesperson for Life in Motion, will be on-site at the Movement Disorders Experience Centers in New York. Ms. Jewell, who is challenged with spasticity associated with her cerebral palsy, achieved acclaim early in her career as the first person with a visible disability to appear in an ongoing role on a primetime television series as Cousin Geri in the hit comedy, "The Facts of Life." Currently, she can be seen in the HBO series "Deadwood," as a guest star on Lifetime's "Strong Medicine," and in a soon to be released movie called "Night of the White Pants." In November, Ms. Jewell will receive the prestigious 2005 Gala Victory Award in Washington, D.C. for contributions she has made on behalf of persons with disabilities.

"I'm so happy to be part of the Life in Motion initiative to help the millions of people with movement disorders take control of their care and their lives," commented Ms. Jewell. "What I love about the Movement Disorders Experience Center is not only can help people with a movement disorder better recognize their symptoms, but it also can educate people about what others experience on a daily basis and help them to better identify with someone challenged with a movement disorder."

Ms. Jewell will be joined by other movement disorder patients, physicians and a mime performer who visually demonstrates the unique experiences of people with movement disorders. Educational materials will be available to the public.

"This is an innovative way to educate people about movement disorders," said Susan Bressman, M.D., President of WE MOVE and Chairperson of the Department of Neurology at Beth Israel Medical Center. "If people are more aware of the symptoms of movement disorders, they will be more likely to see a physician experienced in movement disorders. This will enable them to be diagnosed more quickly and receive appropriate treatment."

A leader in the treatment of movement disorders, Beth Israel's Movement Disorders Research Center consists of a multi-disciplinary team staffed by movement disorder specialists, including adult and child neurologists, a neuropsychiatrist, research coordinators, occupational and physical therapists and clinical and research fellows.

Life in Motion Resource Center

The public may also visit the Life in Motion Resource Center at http://www.life-in-motion.org/ and download patient education brochures and information on movement disorders. The Web site includes a mime performance on video, a creative approach to helping viewers better understand the conditions and the quality-of-life challenges that people with a movement disorder experience. The public may also call the Life in Motion Resource Center's automated toll-free number at 1-866-LIM-3136 (1-866-546-3136) to obtain free educational brochures and other materials, including information on diagnosis and treatment options.

About Movement Disorders

Movement disorders are conditions that originate in areas deep within the brain. They are caused by changes to specific regions of the brain and nervous system, the cause of which is mostly unknown. These special areas, which control movement, send chemical messages to other parts of the brain. These signals set off a chain of events that eventually result in contractions or spasms of muscles manifested by involuntary movements, such as tremors, dystonia and tics, or stiffness of muscles as seen with spasticity. In people with a movement disorder, this communication system is disrupted and interferes with the ability to produce and coordinate voluntary movements or the inability to stop unwanted involuntary movements.

"Movement disorders are chronic conditions that can't be completely cured. They can, however, be effectively managed if they are properly diagnosed and treated, allowing patients to live with less pain, less discomfort, fewer limitations and greater confidence," said Stanley Fahn, M.D., H. Houston Merritt Professor of Neurology and Movement Disorders Division Chief, Columbia University in New York City, and past president of the American Academy of Neurology. "The first step is obtaining an appropriate diagnosis, which usually requires referral to a neurologist who is trained to evaluate these complex disorders and is knowledgeable about the latest treatments."

Effective treatment depends on the underlying cause of the condition and may include oral medications; botulinum toxin injection therapy targeted to spastic or abnormally contracting muscles; surgery (including deep brain stimulation); and physical or occupational therapies. In many cases, combinations of several drugs and therapies are used. The effective management of a movement disorder usually involves a multi-disciplinary team of specialists and may include the patient's primary care physician, as well as the neurologist, physiatrist (physical rehabilitation specialist), nurses, and physical, occupational, and speech therapists. Social workers, teachers, and psychologists also may be involved to help patients and their families or caregivers cope with the psychosocial impact of these conditions.

About WE MOVE

WE MOVE is a not-for-profit organization that has been educating and informing the movement disorder community for more than a decade. The mission of WE MOVE is to facilitate the communication of emerging clinical advances and therapeutic approaches to the management and treatment of movement disorders. Through its award-winning, HON-compliant Web sites, and as an accredited provider of continuing medical education (CME), WE MOVE strives to meet the educational needs of healthcare professionals, patients, and caregivers. WE MOVE develops up-to-date training programs and comprehensive, interactive teaching materials to assist the community in deepening their understanding of movement disorders, their pathophysiology, etiology, differential diagnosis, and state-of-the-art interventions. WE MOVE believes that increased knowledge and understanding promote timely, accurate diagnosis, and up-to-date treatment, resulting in a better quality of life for individuals affected by movement disorders.

More than 130,000 people visit the WE MOVE award-winning Web sites each month to access accurate, timely, and balanced information and resources on movement disorders, http://www.wemove.org/ (consumers); http://www.mdvu.org/ (professionals).

The Life in Motion campaign is sponsored by WE MOVE and funded by an unrestricted educational grant from Allergan, Inc.

CONTACT: Christian Pflaumer of Chandler Chicco Agency for WE MOVE, +1-212-229-8491

Web site: http://www.life-in-motion.org/ http://www.wemove.org/ http://www.mdvu.org/

COPYRIGHT 2005 PR Newswire Association LLC
COPYRIGHT 2005 Gale Group

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