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You can help Wikipedia by introducing appropriate citations. Essential tremor
Classifications and external resources | ICD-10 | G25.0 | | ICD-9 | 333.1 | Essential tremor is a neurological disorder characterized by shaking of hands (and sometimes other parts of the body including the head), evoked by intentional movements. The incidence is unknown, but is estimated to be as common as one person in 20, and it is the most common type of tremor and also the most commonly observed movement disorder. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ...
The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ...
The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ...
The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ...
Neurology is a branch of medicine dealing with disorders of the central and peripheral nervous systems. ...
// The hands (med. ...
For other uses of the word head, see head (disambiguation). ...
For other uses, see Tremor (disambiguation). ...
Cause
The cause of the disorder is unknown (idiopathic). While no identifiable and consistent structural abnormality has been demonstrated yet to exist in the nervous system of every person with ET, prominent researchers including Elan D. Louis are searching actively for neurochemical and brain structure abnormalities that might be commonplace among people with ET. Idiopathic means arising spontaneously or from an obscure or unknown cause. ...
The nervous system of an animal coordinates the activity of the muscles, monitors the organs, constructs and also stops input from the senses, and initiates actions. ...
Tremor intensity can worsen in response to fatigue, strong emotions, hunger, cold, or other factors and can be reduced with alcohol in approximately 50 percent of patients. However, an over-reliance on alcohol to control tremor symptoms can sometimes lead to alcohol addiction. Ethanol, also known as ethyl alcohol or grain alcohol, is a flammable, colorless, mildly toxic chemical compound with a distinctive perfume-like odor, and is the alcohol found in alcoholic beverages. ...
There is ongoing controversy as to whether ET is related to Parkinson's disease and whether essential tremor should properly be considered a kind of Parkinsonism. While some research findings appear to suggest that ET patients face a greater than average chance of developing Parkinson's, those findings might be a misleading effect of the widespread difficulty that doctors experience when they try to distinguish Parkinson's symptoms from ET symptoms and arrive at a definitive diagnosis.
Members of an extended family that researchers identify publicly as the "Iowa Kindred" (in order to maintain the family's privacy) develop either Parkinsonism or symptoms that are indistinguishable from ET; their pattern of inheritance for both conditions is associated with PARK4. This very close association between the two in the Iowa Kindred has contributed to a suspicion among researchers that ET might be a "forme fruste" of Parkinson's disease. A French kindred study found that the Ser9Gly variant of the dopamine receptor D3 (DRD3) was strongly associated with ET in 23 out of 30 families studied.[1] An incomplete, abortive, or unusual form of a syndrome or disease, according to The American Heritage® Stedmans Medical Dictionary, 2nd Edition. ...
The dopamine receptors are a class of metabotropic G-protein-coupled receptors with the neurotransmitter dopamine as their endogenous ligand. ...
Diagnosis Usually the diagnosis is established on clinical grounds, but when suspicion exists, other potential sources of tremor (excessive caffeine consumption, recreational drug use, hyperthyroidism) should be excluded. Caffeine is a xanthine alkaloid compound that acts as a stimulant in humans. ...
Recreational drug use is the use of psychoactive drugs for recreational purposes rather than for work, medical or spiritual purposes, although the distinction is not always clear. ...
Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ...
Essential tremor is often found in more than one member of a family (familial tremor), in which case it is usually dominant in inheritance, or it may occur with no family history. Tremors can start at any age, from birth through advanced ages (senile tremor). Any voluntary muscle in the body may be affected, though it's most commonly seen in the hands and arms and slightly less commonly in the neck (causing the patient's head to shake), eyelids, larynx, tongue, trunk, and legs. A resting tremor of the hands is sometimes present, despite the common misunderstanding that a resting tremor is proof of Parkinson's Disease. In medicine, a family history consists of information about disorders that a patients direct blood relatives have suffered from. ...
Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy with the emergence of a newborn infant from its mothers uterus. ...
Alternate meanings: Hand (disambiguation) A human left hand The hand (med. ...
In anatomy, an arm is one of the upper limbs of a two-legged animal. ...
The neck is the part of the body on many limbed vertebrates that distinguishes the head from the torso or trunk. ...
An eyelid is a thin fold of skin and muscle that covers and protects an eye. ...
The pharynx (plural pharynx), or voicebox, is an organ in the neck of mammals involved in protection of the trachea and sound production. ...
A human tongue The tongue is the large bundle of skeletal muscles on the floor of the mouth that manipulates food for chewing and swallowing, (deglutition). ...
ET does sometimes occur in combination with other neurological disorders such as dystonia and benign fasciculation syndrome. However, there is no clear evidence that having ET predisposes a person to one of these disorders. Dystonia (literally, abnormal muscle tone) is a generic term used to describe a neurological movement disorder involving involuntary, sustained muscle contractions. ...
This article needs to be cleaned up to conform to a higher standard of quality. ...
Symptoms Essential tremor (ET) generally presents as a rhythmic tremor (4-12Hz) that is present only when the affected muscle is exerting effort (i.e., it is not present at rest). Any sort of physical or mental stress will tend to make the tremor worse, often creating the false impression that the tremor is of psychosomatic origin. It is typical for the tremor to worsen in "performance" situations, such as when making out a check at a checkout stand. This is probably due to the increased anxiety that a tremulous person experiences in such situations. ET-related tremors do not occur during sleep, but patients sometimes complain of an especially coarse tremor upon awakening that becomes noticeably less coarse within the first few minutes of wakefulness. The hertz (symbol: Hz) is the SI unit of frequency. ...
It has been suggested that this article or section be merged into Muscular system. ...
Please wikify (format) this article or section as suggested in the Guide to layout and the Manual of Style. ...
A psychosomatic illness is one with physical manifestations and supposed psychological cause, often diagnosed when any known or identifiable physical cause was excluded by medical examination. ...
It is commonly assumed among researchers that tremors are not the only symptom of ET.
In disabling cases, ET can interfere with a person's ability to perform tasks of daily living, including feeding, dressing, and activities of personal hygiene.
ET is usually painless, although in some cases tremor of the head or neck causes pain, and writing can become painful quickly for a person with hand tremors who grips a pen tightly in a struggle to maintain control over penmanship. The neck is the part of the body on many limbed vertebrates that distinguishes the head from the torso or trunk. ...
In 1994, J.L. Izquierdo-Alonso and P. Martínez-Martín, et al, reported in the European Respiratory Journal that some ET patients exhibit tremor-related symptoms that mimic bronchial asthma. These patients have involuntary tremors, contractions, and other abnormal phasic activity in the musculature of their upper airway (at a rhythmic frequency of 7-8 Hz), including their glottal structures and laryngeal muscles. The abnormal movements close their airways partially and they exhibit paroxysmal attacks of wheezing, coughing, and dyspnoea that are worsened, not improved, by asthma medications.
Sometimes people with ET develop a raspy speaking voice while their ET symptoms worsen over time. When this dysphonia occurs, it is true even in cases where the person's tremor symptoms were first noticeable during early childhood and, so, is unlikely to be related to commonplace reductions in quality that can gradually affect the speaking voices of some elderly people. Lisp may mean: Lisp programming language Lisp (speech) This is a disambiguation page — a list of pages that otherwise might share the same title. ...
People with ET often report a progressive decline in their sense of balance and their fine motor skills; published research does suggest that an impaired sense of balance might prevent ET patients from walking normally.
Conflicting research results have so far made it difficult for medical researchers to say with certainty that people with ET are more likely than the general population to experience hearing loss and a reduction or complete loss of olfaction, among a wide assortment of other non-tremor symptoms, but credible researchers have published findings that support claims of progressive hearing loss and progressive loss of olfaction in people with ET. Olfaction (the sense of smell) is the detection of chemicals dissolved in air. ...
Some hard research reports suggest people with ET frequently experience mild mental symptoms that include difficulty with "word finding" (remembering an intended word when speaking) and simple short-term memory loss. However, because such symptoms are common with normal aging, it's difficult to determine if these reports are significant.
Other published reports suggest that people with ET experience personality changes that leave them pessimistic, fearful, shy, anxious, and easily fatigued.
While ET is clearly progressive in some cases (sometimes rapidly, sometimes very slowly), and can in severe cases be disabling, it is apparently not life-threatening and does not appear to shorten lifespan. (Some research suggests that people with ET actually live longer than average.)
On April 13, 2005, researchers Julián Benito-Leon and Elan D. Louis presented their findings at the American Academy of Neurology 57th Annual Meeting in Miami Beach that people with ET are more than twice as likely to develop dementia than people who do not have ET. Dr. Benito-Leon told journalists at that time, "We don’t yet know whether the dementia is due to the same underlying problem that is causing the essential tremor or whether it is caused by another problem." In their research, 7.4 percent of people with ET went on to develop dementia, compared to just 3.5 percent in a control group.
Among the recent and provocative peer-reviewed research regarding non-tremor symptoms of ET, these papers are especially noteworthy:
- A Chatterjee, E C Jurewicz, L M Applegate, and E D Louis. Personality in essential tremor: further evidence of non-motor manifestations of the disease. J. Neurol. Neurosurg. Psychiatry, Jul 2004; 75: 958 - 961.
- Lacritz LH, Dewey R, Giller C, et al. Cognitive functioning in individuals with "benign" essential tremor. J Int Neuropsychol Soc 2002;8:125–9.
- Gasparini M , Bonifati V, Fabrizio E, et al. Frontal lobe dysfunction in essential tremor: a preliminary study. J Neurol 2001;248:399–402.
- Lombardi WJ, Woolston DJ, Roberts JW, et al. Cognitive deficits in patients with essential tremor. Neurology 2001;57:785–90.
- Duane DD, Vermilion KJ. Cognitive deficits in patients with essential tremor. Neurology 2002;58:1706 discussion: 1706,.
- Vermilion K , Stone A, Duane D. Cognition and affect in idiopathic essential tremor. Mov Disord 2001;16:S30.
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 --222.123.133.21 09:25, 26 November 2006 (UTC)Superscript text==Treatment== Treatment of ET may or may not be attempted, depending on the severity of the tremor and the physical and social handicaps that implies. Drug treatment may include tranquilizers, beta-blockers, and antiepileptic drugs. Surgical treatments (which are generally reserved for the most severe cases) include botulism toxin injections into the affected muscles, thalamotomy, pallidotomy, and deep brain stimulation – the insertion of a "pacemaker" into the brain. Image File history File links Example. ...
A sedative is a drug that depresses the central nervous system (CNS), which causes calmness, relaxation, reduction of anxiety, sleepiness, slowed breathing, slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ...
Beta blockers (sometimes written as β-blockers) are a class of drugs used for various indications, but particularly for the management of cardiac arrhythmias and cardioprotection after myocardial infarction. ...
The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ...
A cardiothoracic surgeon performs a mitral valve replacement at the Fitzsimons Army Medical Center. ...
Botulism (from Latin botulus, sausage) is a rare but serious paralytic illness caused by a nerve toxin, botulin, that is produced by the bacterium Clostridium botulinum. ...
First introduced in the 1950s, thalamotomy is an invasive procedure, primarily effective for tremors such as those associated with Parkinsons Disease (PD), where a selected portion of the thalamus is surgically destroyed (ablated). ...
Palliodotomy is a procedure where a tiny electrical probe is placed in the brain, which destroys a small number of brain cells that misfunction and cause rigidity. ...
Deep brain stimulation (DBS) is one of a group of treatments involving surgical implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain. ...
The term pacemaker has multiple meanings: In sports, a pacemaker or pacer is a competitor who enters an athletics race with little or no intention of winning, but purely to set a fast pace for other competitors to follow. ...
In animals, the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ...
The two medications that are prescribed most commonly for control of ET symptoms are the anticonvulsant Primidone (Mysoline®) and the beta-blocker propranolol (Inderal®). Primidone, is an anticonvulsant of the pyrimidinedione class whose active metabolites, phenobarbital (minor) and phenylethylmalonamide (PEMA) (major), are also anticonvulsants. ...
Propranolol (INN) (IPA: ) is a non-selective beta blocker mainly used in the treatment of hypertension. ...
Support groups The International Essential Tremor Foundation (IETF) provides information, services and support to individuals and families affected by essential tremor (ET). The organization encourages and promotes research in an effort to determine the causes, treatment and ultimately the cure for ET. The IETF is a worldwide organization dedicated to meeting the needs of those whose daily lives are challenged by ET. IETF, an international non-profit 501(c)(3) organization that derives its support entirely from its membership and the general public, was founded in 1988 and is guided by a board of directors and a medical advisory council. The organization's membership consists of patients, physicians, educators, parents, relatives and volunteers who provide education, community services and funding to help support tremor research.
The US-based Tremor Action Network (TAN) describes itself as "the first volunteer only 501(c)(3) nonprofit organization created by people diagnosed with essential tremor." This volunteer-run organisation provides a website with forums, FAQs, and recently started carrying a newsletter on its website.
The National Tremor Foundation (NTF), founded in 1992, is a British friendly organisation based in Essex, England, an affiliate of the International Tremor Foundation, which was founded in 1988. The organisation's primary work is production of a quarterly informational newsletter. The NTF also maintains a list of ITF medical advisors, and facilitates the formation of self-help groups. NTF was granted charitable status in 1994.
WE MOVE (Worldwide Education & Awareness in Movement Disorders) is a comprehensive resource for movement disorder information and education (including essential tremor)and the only organization of its kind. Since 1991, this 501(c) 3 not-for-profit organization has been educating and informing patients, professionals, and the public about the latest clinical advances, management, and treatment options for neurologic movement disorders. At WE MOVE, we believe that increasing knowledge and understanding promote timely, accurate diagnosis, and up-to-date treatment, resulting in a better quality of life for individuals affected by these often devastating conditions. Professional education for healthcare professional is also available at the Movement Disorder Virtual University at MDVU.org.
Help with Technology Tunic Software has released software to help people with essential tremor, Parkinson's Disease, and other causes of hand tremor control their computer mouse. Called 'MouseCage', the software automatically smooths mouse cursor motion to reduce the effects of unsteady or shaky hands. MouseCage anti-tremor mouse software Operating a mechanical 1: Pulling the mouse turns the ball. ...
IBM created a peripheral device that filters out tremoring movements of the hand. The hardware adapter, termed AMA, is connected between the computer and the input device. It is switched on or off and adjusted for tremor severity right on the device.
IBM also offer a free smoothing mouse driver for windows 2000 and XP which uses the same technology that helps steady the image in a hand held camcorder. See http://www.alphaworks.ibm.com/tech/mousesmoothing
Another option is http://www.steadymouse.com/about/
Other tools have also been adapted for people with tremors; for example, eating utensils which are weighted to help damp out tremor.
References - ^ Jeanneteau F, Funalot B, Jankovic J, et al. (2006). "A functional variant of the dopamine D3 receptor is associated with risk and age-at-onset of essential tremor". Proc Natl Acad Sci U S A 103 (28): 10753–8. PMID 16809426.
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