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A rough shaking.

This title of a novel by the 19th century Scottish author George Macdonald could well describe the feelings of the estimated 3-4 million Americans who are affected by essential tremor (ET).

Like Parkinson's disease, with which it is often confused, ET can be embarrassing, incapacitating, 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, 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 that there is no effective medical treatment for ET, so-called beta-blockers such as propranolol 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.
COPYRIGHT 1992 Benjamin Franklin Literary & Medical Society, Inc.
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Title Annotation:essential tremor
Publication:Medical Update
Date:Jun 1, 1992
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