dystonia

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Essential tremor – what it is and why you need to know

Essential tremor

Essential tremor

Essential tremor is a type of uncontrollable shake or tremble of part of the body.

Most people with essential tremor experience a trembling, up-and-down movement of the hands.

The arms, head, eyelids, lips and other muscles can also be affected. A tremor in the voice box (larynx) may cause a shaky voice.

Essential tremor is usually more noticeable when you’re trying to hold a position or do something with your hands, such as write. It doesn’t always affect both sides of the body equally.

Essential tremor is a common movement disorder affecting around four out of 100 adults over 40 years of age. Some people only have a mild tremor at first, which usually gets more severe over time.

‘Normal’ tremor

Everyone has a very minor tremor when carrying out daily activities. For example, your hands will shake slightly when you hold them out in front of you. This is normal.

Sometimes, the everyday level of tremor can become more noticeable, particularly in older people. Noticeable tremor is also normal and it’s often caused by a raised level of adrenaline in the body, which can happen when a person is stressed, anxious or angry.

When does a tremor become a problem?

Essential tremor is more severe than normal tremor and it gradually gets worse over time. Eventually, the tremor may become so severe that carrying out normal, everyday activities can become difficult.

Certain things may temporarily increase any tremor, including:

tiredness caused by strenuous activity or lack of sleep

smoking

caffeine – from tea, coffee and some fizzy drinks

being very hot or cold

taking certain medicines – including some antidepressants and treatments for asthma

When to see your GP

It’s important to visit your GP if you experience frequent or severe tremors.

Although there’s no specific test to diagnose essential tremor, your GP can carry out a physical examination and may request further tests to rule out other conditions (see causes, below).

They’ll also ask about your personal and family medical history as part of their assessment.

Treating essential tremor

There’s no cure for essential tremor, but medicines can be used to help improve the symptoms in at least half of people with the condition.

In rare cases, a severe tremor may be treated with surgery if it doesn’t respond to medication.

Read more about treating essential tremor.

Inherited essential tremor

Essential tremor can run in families and research suggests it’s passed on by a faulty gene. At least half of people with the condition have a family member who also has it.

However, the age at which a tremor develops and its severity can vary greatly between different family members. Some people may also develop the faulty gene without inheriting it from either parent.

Other causes of tremor

There are a number of conditions which may cause tremor, including:

overactive thyroid (hyperthyroidism)

Parkinson’s disease, a long-term condition affecting the way the brain co-ordinates body movements

multiple sclerosis, a condition of the central nervous system (brain and spinal cord) affecting the senses and the body’s actions

dystonia, a range of movement disorders which cause involuntary muscle spasms

stroke, which very rarely may result in tremor with few other symptoms

peripheral neuropathy, where the peripheral nervous system is damaged

A tremor can also be one of the withdrawal symptoms for people who are dependant on alcohol and have stopped or reduced their alcohol intake.

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Dystonia – what is Dystonia and who can be affected?

Dystonia

Dystonia

Introduction

Dystonia is a medical term for a range of movement disorders that cause muscle spasms and contractions.

The spasms and contractions may either be sustained or may come and go.

Movements are often repetitive and cause unusual, awkward and sometimes painful postures. Tremor (shaking) can also be a characteristic of some types of dystonia.

Dystonia is thought to be a neurological condition (caused by underlying problems with the brain and nervous system). However, in most cases, brain functions such as intelligence, memory and language remain unaffected.

Types of dystonia

Dystonia can affect only one muscle or a group of muscles. There are five main types of dystonia:

Focal dystonia – where a single region, such as the hand or eyes, is affected. Cervical dystonia, blepharospasm (abnormal twitch of the eyelid), laryngeal dystonia and writer’s cramp are all examples of focal dystonia. If it only affects someone during specific activities, such as writing, it’s described as task-specific dystonia.

Segmental dystonia – where two or more connected regions of the body are affected. Cranial dystonia (blepharospasm affecting the lower face and jaw or tongue) is an example.

Multifocal dystonia – where two or more regions of the body that aren’t connected to each other, such as the left arm and left leg, are affected.

Generalised dystonia – where the trunk and at least two other parts of the body are affected. The legs may or may not be affected.

Hemidystonia – where one entire side of the body is affected.

About 90% of all cases are either cervical dystonia (which affects the neck muscles) or blepharospasm (which affects the eyelids). These are both focal dystonias that tend to develop later in life. They don’t usually get any worse and no other muscles are affected.

Read more about the symptoms of dystonia.

Causes of dystonia

Exactly how dystonia develops remains uncertain, but it’s thought to be caused by a problem with the part of the brain that controls muscle movement (the basal ganglia).

If there’s no identifiable cause of dystonia, or if the cause is genetic, it’s described as primary dystonia.

Secondary dystonia is where dystonia occurs as a symptom of an underlying condition or injury. Common causes include stroke, brain injury, encephalitis and Parkinson’s disease.

Read more about the causes of dystonia.

Diagnosing dystonia

Dystonia is diagnosed by a specialist examining and recognising the typical symptoms. The type of dystonia is then classified by which area of the body is affected.

When diagnosing dystonia, it’s important to confirm whether you have primary or secondary dystonia, because this may determine the type of treatment you need.

If you have typical signs of late-onset focal dystonia, specific investigations may not be required. However, tests may be needed to confirm whether you have primary or secondary dystonia. These may include brain scans, urine or blood tests, and genetic testing.

Read more about how dystonia is diagnosed.

Treating dystonia

There’s no cure for dystonia, but the condition can usually be effectively managed.

Treatment will vary, depending on the type of dystonia you have and the precise nature of your symptoms. However, the four main types of treatment are:

botulinum toxin – widely used to treat neurological conditions that involve abnormal muscle contractions, such as dystonia; it’s injected into the affected muscles to temporarily weaken them and reduce spasms

medication – such as anticholinergics, Baclofen and muscle relaxants

physiotherapy – where exercises are used to improve range of motion and posture, and prevent muscle weakness

surgery – if other treatments are unsuccessful, the nerves controlling the muscles causing spasms can be cut (selective peripheral denervation), or electrodes can be implanted within the brain, which are connected to a small device that’s similar to a pacemaker (deep brain stimulation)

Read more about how dystonia is treated.

Outlook

Dystonia is an unpredictable condition. It tends to progress slowly and the severity of a person’s symptoms can vary from one day to another.

Focal dystonia usually progresses gradually over a period of about five years and then doesn’t get any worse.

Sometimes, a person’s symptoms improve or disappear completely. This is known as total remission and it’s thought to occur in around 5-10% of people.

 

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Deep brain stimulation – find out about this treatment for Parkinson’s disease, OCD, Essential Tremor and Dystonia




Deep brain stimulation – find out about this treatment for Parkinson’s disease, Obsessive Compulsive Disorder, Essential Tremor and Dystonia.

Deep Brain Stimulation
Source: Mount Sinai Hospital




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Dystonia Awareness Week – Join the social media thunderclap and help raise Dystonia awareness!


Dystonia Awareness Week

Dystonia Awareness Week

Even you have visited this site before you will know that as well as promoting awareness of different health conditions I am also of the view that social media represents a game changer as far as healthcare is concerned.

This week is Dystonia Awareness Week and the organisers are organising a social media thunderclap to promote the week. I would urge all my readers to take part and help change the perception of dystonia. You can sign up below!


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So what is dystonia? The excellent Dystonia UK describe it as follows. “Dystonia is an incurable neurological condition that affects around 70,000 people in the UK. The condition causes involuntary muscle spasms that force the body into disabling movements and postures. Dystonia can affect muscles in almost any part of the body, resulting in symptoms such as functional blindness, severe twisting of the neck and debilitating contortion of the hands. It can cause difficulties with movement, eating, talking, writing, reading and sometimes even sitting up. Pain and social isolation are also common.”

Finally can we suggest you have a look at Dystonia UK’s website here.

Thanks very much for taking part in the social media thunderclap.