A rough shaking.This title of a novel by the 19th century Scottish author George Macdonald George MacDonald (December 10, 1824 – September 18, 1905) was a Scottish author, poet, and Christian minister. Though no longer well known, his works (particularly his fairy tales and fantasy novels) have inspired admiration in such notables as W. H. Auden, J. R. R. could well describe the feelings of the estimated 3-4 million Americans who are affected by essential tremor Essential tremor An uncontrollable (involuntary) shaking of the hands, head, and face. Also called familial tremor because it is sometimes inherited, it can begin in the teens or in middle age. The exact cause is not known. (ET). Like Parkinson's disease Parkinson's disease or Parkinsonism, degenerative brain disorder first described by the English surgeon James Parkinson in 1817. When there is no known cause, the disease usually appears after age 40 and is referred to as Parkinson's disease. , with which it is often confused, ET can be embarrassing, incapacitating in·ca·pac·i·tate tr.v. in·ca·pac·i·tat·ed, in·ca·pac·i·tat·ing, in·ca·pac·i·tates 1. To deprive of strength or ability; disable. 2. To make legally ineligible; disqualify. , and can worsen with time. Unlike Parkinson's, it is not life-threatening. Nonetheless, the shaking hands that make eating and drinking difficult, or a shaking head and voice that lead to avoidance of social contact, can greatly reduce the quality of the victim's life. ET is called "essential," because its specific cause is unknown. The most common of all neurologic conditions, it can start in adolescence or adulthood. The mean age at onset is 45 years. Among more than half the cases, the disease runs in families as a genetic disorder. The offspring of an affected individual has a 50 percent chance of acquiring it. Tremor is the only manifestation of the disorder, unlike other neurologic disease (e.g., cerebral palsy cerebral palsy (sərē`brəl pôl`zē), disability caused by brain damage before or during birth or in the first years, resulting in a loss of voluntary muscular control and coordination. , alcohol withdrawal, Parkinson's, etc.) in which tremor is only one of the signs and symptoms. Unfortunately, relatively little research has been done on ET, and it is often misdiagnosed by physicians as anxiety or Parkinson's. It is certainly a disorder of the central nervous system, but the affected area of the brain is unknown. Contrary to the common misbelief mis·be·lief n. 1. A wrong or faulty belief. 2. A heretical or unorthodox religious belief. Misbelief of painters; painters collectively—Bk. of St. Albans, 1486. that there is no effective medical treatment for ET, so-called beta-blockers such as propranolol propranolol /pro·pran·o·lol/ (-pran´o-lol) a ß, used as the hydrochloride salt in the treatment and prophylaxis of certain cardiac disorders, the treatment of tremors and of inoperable pheochromocytoma, and the prophylaxis of migraine. and primidone often suppress the tremor and improve the functional disability. They cannot, however, be used by patients who have asthma or heart disease. Many patients, once they know that their tremor is not due to other disease or is not related to some psychological disorder, soon learn just to "live with it." They avoid eating soup in public, use a straw for drinking liquids, and may need help with such simple tasks as signing checks or threading a needle. Most important to ET patients is the realization that the disease does not affect judgment and intellectual control. For more information about ET, contact the International Tremor Foundation, 360 West Superior Street, Chicago, IL 61610, or telephone (312) 664-2344. |
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