Benign Essential Tremor vs. Parkinson’s Disease: What’s the Difference?
No one wishes for a chronic, long-lasting medical condition but some are more dreaded than others – especially if there’s no cure. Diseases that involve neurological deterioration are particularly fearful. They affect the brain and/or nervous system. They include deteriorating conditions like MS, ALS, Huntington’s disease, Alzheimer’s disease, Parkinson’s disease and others.
When a person develops an involuntary rhythmic shaking it is normal to be worried because a tremor of the hands, head or other part of the body can be a symptom of Parkinson’s disease (PD). However, the most common involuntary movement disorder, benign essential tremor (ET), is in a neurological class of its own. It is estimated that 4% of people over 40 have ET, affecting at least 10 million North Americans. Unlike PD, it is more apt to cause minor impairments, inconvenience, and embarrassment.
Nonetheless, when trembling of the hands, face or neck begins, it is common for patients to worry that they have PD. There are several ways to tell PD from ET, and specialists called neurologists are trained to tell which is which, thus putting the minds of ET patients at rest.
|Frequency of tremor||Slower frequency||Higher frequency|
|Occurrence||More often during rest||More often during activity|
|Associated movement issues||Tremor is primary, other movement problems less common||Slow, smaller, stiff movements; developing balance problems|
|Age at diagnosis||Usually after 40||Usually 55-65|
|Location in body||Usually symmetrical on both sides of the body; hand involvement is most common, but head neck and voice can be affected.||Usually begins on one side and asymmetrically progresses to the other side, hands and legs most often affected; stooped posture and facial “frowning” are evident.|
|Drinking alcohol||May lessen tremor||No effect on tremor|
|Medications||Primidone or Propranolol may improve tremor||Levodopa may control symptoms|
|Amplitude (distance of oscillation)||Amplitude increases with intention (e.g. as hand approaches an object to pick up)||Higher amplitude in general|
|Genetics||50% of cases||Less than 10% of cases|
|Effect of stress/anxiety||Symptoms can worsen||Symptoms can worsen|
|Treatment||Medication, physical/occupational therapy, surgical procedures, MRgFUS (see below)||Medication, exercise programs, surgical procedures, MRgFus|
Magnetic Resonance Image-guided Focused Ultrasound (MRgFUS)
For ET patients with tremors that are poorly controlled by medication, the Sperling Medical Group offers an FDA-cleared treatment called MRI-guided Focused Ultrasound (MRgFUS). This procedure, done under the treatment planning and guidance of MRI, has the potential to eliminate or greatly reduce tremors without surgical incisions or drilling a hole in the skull.
If you or a loved one has ET that is not responding to medication, contact Sperling Neurosurgery Associates for more information.