Dr. Joon Faii Ong is a medical researcher and doctor who specializes in the treatment of Essential Tremors. In this article, Dr. Ong discusses the root causes of Essential Tremors and how you can effectively manage them for a higher quality of life.

What are Essential Tremors?

Essential Tremors are defined as tremors that cannot be controlled by medication. Such tremors are often seen in the upper limbs, neck, and face. An upper limb tremor is typically rhythmic, with a frequency somewhere between four to ten hertz (cycles per second). The severity of this tremor can vary from mild to severe.

Essential Tremors are sometimes accompanied by other symptoms such as headache, insomnia, constipation, and fatigue. These symptoms will vary from person to person, depending on the causes of their disease. Essential Tremor is most commonly seen in patients above 60 years old, but it has also been reported in patients as young as ten years old with no age limit in between.

What Causes Essential Tremors?

There are five types of Essential Tremor: familial, post-traumatic, drug-induced, metabolic, and essential tremor (idiopathic). The exact cause for essential tremor is still unknown, but it has been suggested that impaired neurotransmission in the cerebellum may be involved. A review published in the journal Nature revealed that patients with essential tremors had lower GABA (Gamma-Aminobutyric Acid) receptor gene expression in the cerebellum.

Drugs That Cause Essential Tremors

Certain medications have been found to induce tremors as a side effect resulting from their pharmacological actions. For example, caffeine, nicotine, and certain anti-hypertensive drugs have triggered tremors due to their dopaminergic effects. On the other hand, Beta-blockers can induce tremors by suppressing catecholamine production, an essential neurotransmitter in the body.

What are Dopaminergic Drugs

Dopaminergic drugs are medications that modulate the neurotransmitter dopamine. Dopamine is one of the chemicals in the brain and nerves that make people feel happier and more active. However, there is a shortage of dopamine among Parkinson’s Disease patients, resulting in muscle rigidity and tremors.

What Can be Done to Treat Essential Tremors

There are currently four major treatment options for Essential Tremor: medications, Deep Brain Stimulation, Botox Injections, and Surgery. Medications can be administered to suppress tremors, but they have side effects of their own that may just worsen the condition in the long run. Deep brain stimulation has proven effective for treating Parkinson’s disease and dystonia, but the FDA has not approved it for use in Essential Tremor patients.

Botox Injections can be used to treat certain types of tremors; however, Botox injections are only effective for about six months at a time. Surgical options like thalamotomy or pallidotomy involve using an electrode to destroy a part of the thalamus, resulting in permanent numbness, slurred speech, and weakness on one side of the body.

What is the Prognosis for Someone with Essential Tremors?

Unfortunately, there is currently no effective cure for Essential Tremor, and the disease will progress as time passes. While medication can reduce tremors, they still do not slow down the progression of the disease. Fortunately, medical researchers are working hard to find more efficient ways to treat this condition, such as gene therapy and stem cell transplantation.