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Tremor hereditary essential

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.

Read more at Wikipedia.org


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Essential tremors
From Saturday Evening Post, 1/1/05 by Loetta Southworth

I read the article in The Saturday Evening Post about essential tremor and was so excited. I called my fiance and read it to him. We were both hoping that someday someone would start studying essential tremor. We can't find very much about it. We've joined support groups. They send articles perodically. I read every one of them.

All my fiance's doctors want to do is give him drugs, and they all make him druggy, so he won't take them.

We heard about a physician in Portland, Oregon, who did the brain surgery on a lady, and the very minute he did whatever he did in the brain, her right hand stopped shaking. The last time we heard, he was getting ready to do the left side, but we have not been able to find out the doctor's name or anything about all of it.

When my fiance gets upset in the least little bit, his hands shake unbelievably. We shall be waiting patiently for a reply.

Loetta Southworth

Springfield, Oregon

Re: the article about essential tremor in the Sept./Oct. 2004 edition:

I found your article on essential tremor very interesting. My late husband had essential tremor beginning in his late 50s. He was a Baptist minister and the shaking in his hands was a great problem for him. He was always in the public eye. He retired early at age 62, and the tremor got worse.

His doctor at Wake Forest University Baptist Hospital sent him out to the University of Kansas Medical Center, where they were to begin a clinical trial with a device to help ET. He was the third one to have the operation. While he was awake, the doctor put tiny wire electrodes in his brain, and they were attached to a small battery-powered device in his chest. The battery was turned off and on with a magnet. This operation was done on March 16, 1994. To his delight, it controlled the tremor in his right hand. It remained controlled for two years and nine months.

On May 17, 1996, he was the first one to have the same operation to control his left hand. It was controlled for about 14 months.

In October 1997 wires were replaced on implant to control the right hand. The company making the wires and implant was Medtronic Neurological in Columbia Heights, Minnesota. They invited Larry to come and speak at their Christmas gala, and he spoke to 2,000 people. They taped it and I have enjoyed it.

My husband wasn't sure these operations would help him, but even if they didn't, he hoped the research would help others and especially his children, since it is hereditary. There was an article about Larry in Parade Magazine. After that he received phone calls from all over the United States from people with ET, asking about his experience. He said it seemed like it was his second ministry encouraging people. The local TV station in Winston-Salem interviewed him, as did the Winston-Salem Journal. I'm enclosing a copy of these articles.

I thought you might be interested in someone who had essential tremor and how he dealt with it.

Mrs. Lawrence L. Abt, Jr. East Bend, North Carolina

Editor's note: Essential tremor of the hands occurs usually when the hands are in use. Tremor from Parkinson ' s is most common when the hands are at rest.

No studies show that ET increases one's risk of getting Parkinson's.

COPYRIGHT 2005 Saturday Evening Post Society
COPYRIGHT 2004 Gale Group

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