Sunday, November 8, 2020

Shaking: An Annoyance or Parkinson’s Disease?

 

Shaking: An Annoyance or
Parkinson’s Disease?
W. Gifford-Jones, M.D. and Diana Gifford-Jones
It’s fair to say, these are shaky times! In keeping with the
rocky ride of 2020, have you noticed your hands shaking
lately? Are you having trouble tying your shoes, signing
your name, or embarrassed that the glass your holding is
shaking? You think of those suffering from Parkinson’s
disease. And you wonder if you are experiencing first
signs of this trouble.
Parents may also have concerns if their child has shaky hand movements. A report from the
University of California says that a condition called essential tremor can occur in young children
and young adults. This problem increases with age. At around age 60, about 5% of people
notice a slight tremor. Another study states that about 1% of the population suffers from
tremor.
Essential tremor is the most common form and usually involves the hands and arms, less often
other parts of the body. It occurs with movement, not at rest.
This slight shaking can also affect the head, with movement from side to side, or up and down.
On rare occasions, it involves the vocal cords, and the voice becomes halting. It may also be
associated with poor balance.
No one is certain of the cause. Researchers are studying a part of the brain called the cerebellum
which plays a role in movement and muscle control.
Doctors can usually make the diagnosis when symptoms have been present for at least three
years and no other signs of neurological disease are evident. But there are differences
between essential tremor and Parkinson’s disease that help doctors to distinguish one from
the other.
For instance, considering statistical chances is helpful. Essential tremor is approximately eight
times more common than Parkinson’s disease.
Essential tremor normally occurs during action, such as writing, eating or extending an arm to
shake hands. But in Parkinson’s disease, the tremor occurs when the arm is not being moved.
This is a “resting tremor”.
There’s a difference in the tremor’s frequency and the magnitude. For essential tremor, it’s
usually of higher frequency, with more repetitions over a length of time. In Parkinson’s disease,
the frequency of movement is slower.
A look to relatives may provide clues. A family history of essential tremor exists in more than
50% of cases; whereas in Parkinson’s disease, only 10-20%.
In terms of symptoms, in essential tremor, the primary issue is anxiety regarding the shakiness.
In Parkinson’s, other symptoms appear apart from the tremor, such as rigidity, slowed
movements and balance issues.
Treatment of the two is different as well. The majority of people who have essential tremor do
not require treatment. In fact, researchers report that those with this condition rarely bother to
seek treatment. Or they wait for many years before seeing a doctor.
A change in lifestyle may ease mild tremors. Since sleep deprivation aggravates tremors, the
answer is to get more shut-eye.
There is little doubt that anxiety plays a major role with tremor. Sufferers indicate they try to
avoid stressful activities such as public speaking due to the visibility of hand tremors. Yoga,
stretching and relaxation exercises can be beneficial. Alcohol also has a moderating effect on
tremor as long as used in moderation. Smoking must be eliminated as nicotine aggravates
tremor.
For patients with Parkinson’s disease, alcohol has no effect on the disease. But drugs such as
levodopa usually provide some improvement of symptoms.
And for parents who notice a child with shaky hands, have a doctor follow the case and keep
a journal of what you see. As the child grows and becomes self-conscious of tremors, help
them gain confidence through understanding of essential tremor.
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