Q: My family and I (two grown children) have benign essential tremor and would like to know if there is a cure. I was disappointed in your article of four years ago because it sounded like any tremor had a serious illness connected with. No one else in the family has had this tremor, so it apparently started with me.
My symptoms are minor but my kids (over 50) have more pronounced head tremors. Any solution?
A: Benign essential tremor is an inherited neurological disorder that can affect almost any part of the body but is most commonly noted in the hands, head, arms, legs, and voice. While not dangerous, it tends to worsen over time and can be more severe in some individuals than in others. It can occur at any age but is most common in individuals 40 and older.
Symptoms may exacerbate when an individual is fatigued, has consumed too much caffeine, is under stress, or even when exposed to major temperature changes. Almost 50% of all cases of essential tremor are believed to result from a genetic mutation, yet it isn’t clearly understood what causes the condition in those individuals without the genetic mutation. The genetic form is autosomal dominant, meaning that a defective gene from only one parent is necessary to pass the condition on.
Diagnosis is accomplished primarily by a physician performing an examination that includes such things as checking tendon reflexes, gait and posture, ordering lab work, and by ruling out other conditions that may have similar symptoms. I don’t want to add to your concern and stress by indicating once again that this tremor may have an underlying medical basis; however, tremors may have an underlying disease process. Thus, it is likely your primary physician or neurologist will want to rule out some conditions.
Once a diagnosis has been made, treatment may be in the form of a beta blocker (prescription oral medication) which is commonly ordered to treat hypertension, anti-seizure medications, Botox injections that may help voice tremors, physical and/or occupational therapy and lastly, surgery. In the instance when Botox is used to help control hand tremors, the treatment can weaken the fingers. When used for voice tremors, it can cause hoarseness and dysphagia (difficulty swallowing). Surgery, in this and almost all cases, is last on the list for treatment because of the increased risk for potential gait abnormalities, weakness, motor control, and more. On the upside, deep brain stimulation has been found to be very effective.
On the home front, you and your children might practice relaxation techniques in an effort to reduce the intensity of the tremors. Such things as meditation, yoga, tai chi, discontinuing caffeine, and limiting the amount of alcohol consumed are believed to be beneficial.
We all respond differently to all disorders, diseases and ailments. Fortunately, your case appears somewhat mild at this stage as opposed to your daughters having more pronounced symptoms. If they aren’t on medication for benign essential tremor, they may both choose to speak with their respective physicians in this regard. Research is ongoing in this and all fields and hopefully there is something new on the horizon to keep their symptoms from progressing. Good luck.
