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Improving Surgical Care Options

Essential Tremors

Essential tremors are thought to be due to electrical irregularities in the brain that send abnormal signals to the muscles. It is a progressive condition that worsens over time and is linked to genetic disorders that typically appear over 40 years old.

Essential tremors usually occur alone and without any other neurological symptoms or signs. Sometimes misdiagnosed as Parkinson’s disease, essential tremors are an involuntary rhythmic shaking of the hands that is not present at rest. It is apparent during activities such as drinking, writing and eating. Symptoms can worsen due to stress, anxiety, smoking, caffeine, and fatigue.

Genetics Home Reference estimates that as many as ten million people in the U.S. are affected by the disease. For some patients, using wrist weights may ease symptoms allowing the patient to function. Other patients may also use relaxation techniques as stress can increase symptoms. Medical therapy is also used to treat patient’s symptoms. Primidone is typically the first drug prescribed as it has had success in some situations for epilepsy. Botox is also used at times to control head tremors. When these fail, surgery is an option.

A surgical procedure used years ago created lesions in the ventral intermediate thalamus and was highly successful with treating essential tremors but is no longer commonly used due to the risk of developing speech problems. Deep brain stimulation (DBS) is a current surgical option. Unlike some surgical therapies, DBS is reversible and programmable, helping to adjust the settings to maximize patient benefit.