5 Key Points to Keep in Mind about ET

Category: Essential tremor
Key words: Essential tremor, research, brain abnormality, tremor progression, systemic treatment, neurosurgery, MRI-guided focused ultrasound, deep brain stimulation, support group
5 Key Points to Keep in Mind about Essential Tremor

Millions of people have involuntary, uncontrollable tremors of the hands, head, voice or other body parts. When tremors are not the result of another disease (such as Parkinson’s disease), or a side effect of medication or drugs, or caused by injury or exposure to a toxic substance, the condition is called Essential Tremor (ET). Roughly half of cases seem to run in a person’s family and are assumed to have a genetic component—though to date, no gene has been identified to account for all familial tremors.

ET is progressive, meaning it can get worse. In fact, it can progress to a point at which the person is quite disabled. Not only do the daily tasks of life become quite impossible, but tremors may also cripple a person’s social life, self-esteem, and emotional ability to cope.

What’s important to keep in mind?

Here are five key points to remember about ET:

  1. In terms of what triggers the onset of tremors, no one knows. Tremors can begin at any age, but no one has yet been able to identify a cause. This means there is also no known cure or way to prevent ET. While these may seem discouraging, be assured that research is being carried out in every part of the globe in hopes of discovering the root cause and developing a cure for it.
  2. ET is not universally identical among those who have it. ET is now considered a group of brain abnormalities that produce similar types of tremors. This helps explain why a medication that helps one person does not even make a dent in another person’s “shakes”.
  3. Since there is no known cure, treatments are aimed at controlling tremors. The treatment approach depends on the degree of tremor. For example, mild hand tremors may respond to stress management, cutting down on caffeine, physical therapy, devices such as a weighted glove or special eating utensils. As tremors worsen, prescription medication such as Primidone or Propranolol may help. Some people try Botox injections. Again, what works for one person may not be effective for another.
  4. Medications aimed at controlling tremors are systemic, meaning dispersed throughout the body. Thus, many people who use pharmaceuticals experience side effects, especially if the dosage needs to be increased in response to tremor progression. If side effects are too great a trade-off (the unpleasant effects are greater than the benefits) then the medication will be stopped or a new one may be tried. A growing number of those with severe tremors that can no longer be controlled by medications turn to neurosurgical interventions such as noninvasive MRI-guided Focused Ultrasound or invasive Deep Brain Stimulation. These are not “cures” in the true sense of the word, but they interrupt the tremor signals from the brain to the hand at a particular location in the brain. They are effective and because they are locally focused, nothing is dispersed in the body to cause side effects.
  5. If you have ET, you are not alone. There are active support networks that are easily accessed on the internet. Some of them are individual “groups” or “threads” within a very large patient organization such as Inspire.com. Others, like Sperling Neurosurgery Associate’s ET facebook group, are dedicated strictly to ET and are by membership (we invite you to check it out and join the group). In such forums, members whose social life feels like it’s shrinking because of embarrassment when out with others can find understanding, compassion, and hope through shared stories and tips. Also, the International Essential Tremor Foundation offers terrific resources and creative ideas.

While ET can be demoralizing and depressing, try not to give in to pessimism. Your family and loved ones, your clinical team, and the wealth of online resources all exist to encourage and support you while science works hard to achieve an end to ET.

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.

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