Parkinson’s vs Essential Tremor

Parkinson’s disease (PD) and essential tremor (ET) show many similar symptoms as neurological disorders, which makes them difficult diseases to differentiate. By monitoring the onset and severity of your symptoms, you can help physicians during the diagnostic process. Diagnosing PD or ET can be a lengthy process, so it is important to be vigilant in recording your new or worsening symptoms. In this blog, we will compare and contrast PD and ET in order to help you better understand your disease.

What is Parkinson’s?

PD  is a brain disorder that affects the nerve cells, and causes shaking in the hands, arms, legs, jaw, or head, stiffness of the limbs and trunk, and difficulty with balance. Most PD symptoms start with tremors on one side of the body, and in most cases, these tremors begin at the hands.  When PD progresses, these symptoms can worsen and other non-motor symptoms may present, including sleep problems, fatigue, and depression. While we have just provided a scientific breakdown of PD, the truth is that PD is unpredictable. It is hard to know whether or not you are going to end up with PD, especially if none of your relatives have been previously diagnosed.

What is the essential tremor?

Essential tremor is a neurological condition that causes shaky hands, voice changes, and other uncontrolled movements. The cause of ET remains unknown, but research has concluded that 50% of cases can be attributed to genetics. Treatment options including medications and surgeries are unique for each patient.  A treatment that works for one patient may provide little relief to another. Most people with ET notice their tremor is most prominent when trying to hold a cup or write. It is possible for ET to improve if the individual receives the appropriate medical attention.

What are the main differences between Parkinson’s and Essential Tremor?
  1. Symptoms

ET usually starts on one side of the body, particularly the hands.  PD, on the other hand, usually presents as tremors in both hands. PD  tremoring is more intense when the person is walking or resting their hands, while ET tremors are usually apparent when performing an action or a task with the hands.

In most cases, ET symptoms begin gradually and worsen with time. In addition, ET tremors worsen with prolonged movement. Another common symptom of ET includes tremors in the head and neck.

Differences between PD and ET symptoms:

  • When the tremor presents: Essential tremors are highly related to movements, unlike PD tremors that are common while resting.
  • Associated conditions: Generally speaking, ET is not associated with additional health problems. On the contrary, PD can cause additional health problems including posture issues, slow movement, and shuffling gait.
  • Affected body parts: Most people with ET notice their tremors being especially severe in their hands, voice, and head. People with PD notice their tremors in similar places, including the hands, chin, legs, and other body parts.

2. Diagnosis

Experiencing a slight hand tremor when you are stressed or anxious is normal, and in most cases, nothing to worry about.  A person with PD or ET will notice they are tremoring at times when it is unprovoked by an anxious event, which is what often leads them to seek medical attention. PD is diagnosed by the process of elimination. There is no official blood test, or neurological scan that can be performed to confirm that someone has PD. Rather, physicians use tests to rule out other neurological diseases and then conclude that the patient has PD. 

Similarly, there is no official test to diagnose ET. Rather, through symptom observation, laboratory tests, neurological examinations, and recording family history, a physician can conclude that a person has ET. Before making a final diagnosis, physicians may recommend that the patient alters their diet by cutting out caffeine, alcohol, or other prescribed medication.  This is because hypothyroidism, a condition affecting your metabolism, may present itself as a tremor.  Cutting out these foods and medications can help physicians to rule out hyperthyroidism as a potential source of your tremors.

3.  Treatment

Unfortunately, there is currently no cure for ET or PD. Thankfully, there are a number of treatment options available which can ease symptoms for patients affected by these diseases. 

The most promising treatment option currently available to PD patients is Levodopa. Levodopa is a dopamine precursor, which is absorbed in the intestine and then transported to the brain, where it can be converted into dopamine.  When a person has PD some of the neurons associated with movement begin to degrade, which causes a loss in the production of dopamine.  As such, levodopa is an effective treatment in restoring dopamine levels. 

Generally speaking, the drugs available to treat PD fall into three categories: drugs that increase dopamine levels, drugs that alter other chemicals in the body, and drugs that help to control the non-motor symptoms associated with PD. 

As for ET, treatment begins with dietary changes. For a patient to be provided with the optimal treatment plan, their previous health conditions and the severity of their tremor must be assessed.  For patients who do not have asthma, physicians will usually prescribe propranolol, which is a drug that aids in reducing the severity of tremors. Sometimes, as the body gets used to medications they become less effective.  If this happens to a person with ET taking propranolol, they may be prescribed primidone, which is another drug that provides the same benefits. Another effective treatment is Botulinum toxin injections, which are especially useful for people who have tremors of the head and voice. Alternatively, when a person’s tremors are unsusceptible to drug therapies, deep brain stimulation can assist in easing their symptoms.

It is easier to manage and treat an ET tremor, compared to a PD tremor. While it is not always easy, there are effective treatment options out there for people affected by both ET and PD.  Your physician will work with you to find the best option for you!

You Are Not Alone

When it comes to progressive diseases like PD and ET, mental health and physical health go hand-in-hand. It is important to know that you are not alone in understanding your disease. In fact, there are approximately 7 million people in the USA with ET and ~1 million with PD. There are numerous websites and foundations which offer helpful information to people affected by these diseases. One foundation is the  International Essential Tremor Foundation, which raises awareness about ET and offers opportunities to join support groups. Joining a support group with people who are affected by the same disease can be a great way to connect with others and gain support.

Tremor Device

Steadiwear has been working tirelessly to perfect the Steadi-Two, which is a device that reduces hand tremors for people with PD and ET. With the Steadi-Two, your hand tremors will be much less severe, and you will be able to get back to doing what you love!

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