Parkinson’s and Essential tremor

Parkinson’s disease:

A progressive neurological disorder of the central nervous system that mainly affects the motor system, but also has non-motor symptoms. The disease damages the nerve cells in a region of the brain that is responsible for dopamine production – the chemical is needed in order to properly control muscles and movement.

 

Essential Tremor:

A common neurological disorder that causes uncontrollable shaking predominantly in parts of the upper body. It occurs when a person tries to use the affected muscles – this makes it an “action tremor” or kinetic tremor; (in Parkinson’s disease both “action” and “resting” tremors are present). It is sometimes misdiagnosed as Parkinson’s disease

Causes

Parkinson’s disease:

The disease is idiopathic, meaning it has no exact cause

Only a small percentage of the cases are associated with known genetic factors (a family history of Parkinson’s disease)

Environmental factors have been associated with a prevalence of the disease: exposure to toxins, pesticides, heavy metals, living in farming areas that use various chemicals, drinking contaminated well water

 

Essential Tremor:

The exact cause is unknown, but the condition is believed to occur due to abnormal electrical brain activity

Another assumption regarding causality implies genetics as about 50% of the cases seem to have an inherited genetic cause

Symptoms and signs

Parkinson’s disease:

Tremor or shaking (first appears in only one arm)

Muscle rigidity

Balance problems

Slowness in movement (hypokinesia) and abnormal movement (akinesia)

Speech is affected: faster or slower rate than normal, less clarity and ability to articulate, stuttering

Voice has a lowered volume and becomes monotonous

Difficulties in chewing and swallowing

Memory and concentration are affected in an advanced stage

Depression

Anxiety (around 40% of those suffering from Parkinson)

Restless leg syndrome

Sleeping difficulties

Fatigue

 

Essential Tremor:

Uncontrollable shaking episodes (when the muscles in upper body parts are used)

“Shaking” voice

Trembling head

Tremors are pronounced when under emotional stress

Tremors disappear when the affected body part is resting

Advice

Parkinson’s disease:

 

Although there is no precise test to diagnose Parkinson’s disease, doctors will proceed to certain examinations in order to rule out other conditions

 

A neurologist gives the Parkinson’s diagnosis based on a neurological and physical examination, following the patient’s medical history and symptoms

 

Blood tests or imaging tests (MRIs, brain ultrasounds) may be requested to exclude other possible health problems

 

Parkinson’s disease medication will be given in order to establish the diagnosis (positive if there are signs of improvement after taking the medication)

 

Physical exercise such as aerobics and stretching is recommended

 

Medication based on carbidopa-levodopa (a substance that passes into the brain and is converted to dopamine) is given

 

Medication that inhibits the breakdown and metabolization of dopamine, dopamine agonists (compounds that activate dopamine receptors in the absence of the actual substance)

 

Surgical interventions are possible: Deep Brain Stimulation (implanting electrodes into the brain; used in advanced stages of Parkinson’s when the response to medication may become unstable)

 

A healthy diet will help in managing some of the discomforts (such as constipation)

 

 

Essential Tremor:

 

There is no specific test for Essential Tremor; the diagnosis is made by ruling out other medical conditions or health problems

 

The doctor will follow your family and medical history, symptoms and suggest a physical and neurological examination

 

Tendon reflexes, muscle tone and strength, sensitivity, posture and coordination will be tested

 

Laboratory tests: blood tests, thyroid disease, alcohol and chemical levels

 

Performance tests: writing, drawing a spiral, keeping arms outstretched

 

Medication: anti-seizure medication, tranquilizers, beta-blockers

 

Botox injections – for head and voice tremors

 

Surgery: Deep Brain Stimulation (in the cases in which medication is ineffective and the tremors are disabling)

MISCONCEPTIONS
  • Parkinson’s disease:

     

    Parkinson’s disease only affects motor abilities

     

    The disease has sudden flare-ups and very rapid progress

     

    Levodopa (medication) stops being effective after five years

     

    The doctor can “predict” your evolution

     

    You should wait as long as possible between medication doses

     

     

    Essential Tremor:

     

    Essential Tremor is a clear sign of Parkinson’s disease

     

    The medication used for Essential Tremor is the same as for Parkinson’s disease

     

    Medication is the only available treatment for Essential Tremor

Statistics

Parkinson’s disease:

 

1 in 7 people that are diagnosed with Parkinson is under 40 years old

 

The average age of diagnosis is over 60

 

About 1 million Americans live with Parkinson’s disease

 

The worldwide estimation is around 7 to 10 million known cases

 

 

Essential Tremor:

 

It is the most common movement disorder and it affects aprox 10 million people in the United States

 

It can appear at any age, but it usually first strikes in adolescence or middle age

Did you know?

Parkinson’s Disease Day is on 11 April (the birthday of James Parkinson) and the symbol used is a red tulip

 

People that suffer from Parkinson’s and have increased public awareness: Michael J. Fox (actor), Davis Phinney (olympic cyclist) and Muhammad Ali (boxer)

 

Parkinson’s disease seems to be more prevalent in men than in women

 

Parkinson’s disease manifests itself differently from individual to individual in terms of intensity, how pronounced the symptoms are, and evolution

 

A “smart” spoon has been developed for people with Parkinson’s or Essential Tremor: https://www.liftware.com/

 

Up to 20% of the people with Essential Tremor have a high chance of developing Parkinson’s disease

 

Some people with Essential Tremor notice an improvement after consuming alcohol. This practice is not recommended at all as their symptoms worsen after the effect wears off and progressively larger quantities of alcohol are needed to feel any improvement. (This may lead to chronic alcoholism.)