Essential Tremor: An Update
Introduction
Essential tremor (ET) is one of the most common movement disorders, affecting an estimated 10 million people worldwide (Lang, Lozano, & Nutt, 2011). It is a progressive, neurologic disorder characterized by a rhythmic, involuntary movement of the hands, head, voice, or other parts of the body (Lang et al., 2011). ET is a disabling condition that can significantly impair quality of life, often causing difficulties with activities of daily living (ADLs) such as eating, drinking, and writing (Lang et al., 2011). The purpose of this paper is to provide an update on ET, including current epidemiology, pathophysiology, diagnosis, and treatment.
Epidemiology
ET is one of the most common neurologic disorders, with a prevalence of 0.4-5.3% in adults (Lang et al., 2011). It is more common in women and in those over 40 years of age (Lang et al., 2011). It is estimated that 15-20% of ET cases are familial, suggesting a genetic component (Lang et al., 2011).
Pathophysiology
The exact pathophysiology of ET is not well understood, but it is believed to be related to dysfunction in the subthalamic nuclei of the basal ganglia (Lang et al., 2011). This dysfunction is thought to result in an imbalance between the excitatory and inhibitory neurotransmitters, leading to overactivity of the thalamus and other brain regions (Lang et al., 2011).
Diagnosis
ET is typically diagnosed based on a detailed patient history and physical examination (Lang et al., 2011). It is important to differentiate ET from other movement disorders, such as Parkinson’s disease, dystonia, and myoclonus (Lang et al., 2011). Electrophysiological testing, imaging studies, and laboratory tests may be used to confirm the diagnosis (Lang et al., 2011).
Treatment
The primary goal of treatment for ET is to improve symptoms and quality of life (Lang et al., 2011). Treatment options include lifestyle modifications, medications, and, in some cases, surgical interventions (Lang et al., 2011). Lifestyle modifications such as stress reduction and avoidance of caffeine and alcohol may be helpful (Lang et al., 2011). Medications used to treat ET include beta-blockers, anticonvulsants, and botulinum toxin (Lang et al., 2011). Surgical interventions such as deep brain stimulation have been found to be effective in some cases (Lang et al., 2011).
Conclusion
In conclusion, essential tremor is a common movement disorder that can significantly impair quality of life. It is believed to be related to dysfunction in the basal ganglia and is typically diagnosed based on a detailed patient history and physical examination. Treatment options include lifestyle modifications, medications, and, in some cases, surgical interventions.
References
Lang, A. E., Lozano, A. M., & Nutt, J. G. (2011). Essential tremor. The Lancet, 378(9802), 1688-1699.