Essential Tremor
Essential Tremor
Intro/definition:
An essential tremor is an neurological disorder. It is commonly characterized as an uncontrollable shaking that occurs in various body parts, such as the head, chin, hands, arms, and also presents with a shaking voice due to affected vocal cords. An essential tremor is different from a resting tremor, which is associated with Parkinson’s, and is commonly classified as an action tremor (Abboud, 2011).
Pathology:
The likelihood of presenting with a resting tremor has been shown to increase with age, in different ethnicities, and in persons with a family history of an essential tremor. The risk of acquiring an essential tremor has been shown to be more prevalent in older populations. An increased risk has also been found in Caucasians opposed to African-American populations.
Genetic factors have been linked to increased prevalence of essential tremors with some studies suggesting potential linkages identified at the 3q13 and 2p22 chromosomes. However, there is a large discrepancy if genetic factors are a cause since other studies found only a moderate link (60-63%) in monozygotic twins and a low link (27-42%) in dizygotic twins. This is indicative that environmental factors likely play a role in the prevalence of essential tremors. A link in β-carboline alkaloids (harmine and harmane) has been found in subjects with essential tremors, since high concentrations of β-carboline alkaloids were found in their blood.
β-carboline alkaloids are found in high meat diets and increased meat consumption has been linked with more prevelance in essential tremors. An increased concentration of lead in subjects with essential tremors was also found in subjects with essential tremor. These environmental factors are very likely causes in essential tremors (Louis, 2001).
Epidemiology:
Assessment/Diagnosis:
Clinical presentation:
Treatment:
References:
<uLouis, D.E., Essential tremor. (2001). The New England Journal of Medicine. 345:887-891.
Abboud, H., Ahmed, A., Fernandez, HH. (2011). Essential tremor: choosing the right management plan for your patient. Cleve Clin J Med. 78(12):821-8.
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