Parkinsons Vs Essential Tremor:
The diagnosis is based on a complete medical/symptom, family and medication history and an examination by a physician, preferably a neurologist who specializes in movement disorders. Obtaining a handwriting sample may be helpful in making advice an accurate diagnosis; in ET handwriting is generally large and tremulous, whereas in PD, micrographia (very small handwriting) is common. An accurate diagnosis is critical as the treatment regimen is very different for the two disorders.
There was no correlation between UPSIT score and tremor severity or disease duration [63]. An expansion of this study including 97 ET cases and 92 controls again found a lower UPSIT score in ET cases than controls [64]. One study involving 723 subjects compared olfaction in PD, ET and control groups [62]. look at more info Subjects with clinically probable PD had significantly lower UPSIT scores compared with the controls but there was no significant difference in UPSIT scores between ET cases and controls [62]. Another study evaluated olfaction in 59 ET cases, 64 tremor-predominant PD cases and 245 controls [65].
There is longstanding controversy surrounding the possible link between essential tremor (ET) and Parkinson’s disease (PD). Inconsistent and unreliable diagnostic criteria may in part account for some of the difficulties in defining the relationship between these two common movement disorders. A 40-year-old woman with a family history of ET develops a kinetic tremor and, a few years later, a postural head tremor. Her tremor worsens considerably such that she has severe and debilitating tremor by the age of 65 years.
However, at this time, researchers and medical professionals are not exactly certain what causes essential tremor. The most common drugs used to treat essential tremor include primidone and propranolol. Propranolol is an anti-epileptic drug and is prescribed when a patient is not responding to primidone. When both drugs failed to improve the tremor, a drug called botox is used in the form of injection. The exact cause behind the loss of neurons in this movement disorder is unknown. However, ongoing research has shown that several factors may play a role in the development of Parkinsons disease, including genetic factors and environmental triggers.
However, both are quite different conditions and there are many ways to differentiate between the two. There are approx 41 million people worldwide are living with this condition. The current estimate shows that 4 out of 100 individuals over the age of 40 are affected by essential tremor. The difference between essential tremor reference and Parkinsons can be so slight that it can be difficult for doctors to diagnose these conditions correctly. In fact, they are often mistaken for one another, which can be frustrating for physicians and patients alike. Specialty physicians that diagnose and treat these conditions are Movement Disorder Neurologists.
Both Essential tremor and Parkinson’s Disease are movement disorders and are caused due to malfunctioning of the motor function capability of the brain. Similarly the treatment for essential tremors can be similar to that of Parkinson’s Disease related tremors. But Parkinson’s Disease medications might not help in treating Essential tremor. The medication of Parkinson’s Disease needs to be enhanced in terms of dosage and frequency with time and progression of the disease but in case of Essential tremor, the medicine dosage or frequency might not necessarily change.
Levodopa is the medication most commonly given to control the movement symptoms of PD, and tremor usually ‘ though not always ‘ responds to levodopa treatment. The TCS examination was performed by 2 experienced sonographers (TAY and XRF, with 10 and 6 years of experience, respectively), who were blinded to the clinical data and other imaging results. To assess the intrarater reliability, a 2nd evaluation (subjects in a different order) was performed 2 hours after the 1st evaluation by the 2nd sonographer, who scored all the images independently. TCS was performed using Toshiba, Aplio-500 (Tochigi, Japan) Ultrasound System, with a 2.5- to 3.5-MHz phased-array transducer at a penetration depth of 14 to 16 cm and dynamic range of 45 to 55 dB. The examination was performed bilaterally through the pre-auricular temporal acoustic window with the patient in the supine position.
Postural tremor amplitude was lower than that of rest tremor in six of 11 PD cases [20]. In that study, the postural tremor in PD cases had a mean amplitude that was 2.7-times higher than the postural tremor in ET cases [20]. Based on clinical experience, we have found that postural tremor of ET and PD may differ in several respects, although published data are lacking.
You may find that your essential tremor does not impact your life enough to seek treatment. You may also find that lifestyle modifications may provide relief for your tremors. Medications, physical therapy, deep brain stimulation and other techniques may be used to manage tremors, depending on how severe they are.
Low levels of dopamine may disrupt the way the brain processes movement, which can result in movement problems. Evidence suggests that many people with Parkinson’s disease lose 60’80% of dopamine-producing cells in the brain by the time they present symptoms. A Parkinsonian tremor has a few distinct characteristics, though it may be easy to confuse with other types of tremors depending on the other symptoms a person shows. Doctors will look for and rule out other types of tremors to confirm their diagnosis. We use the usual Parkinson’s disease medications to treat tremor, but tremor is the least predictable of the four basic motor problems of Parkinson’s disease in its response to medication treatment.
The mean duration of PDconv was shorter than that of PD but was sufficient to exclude atypical PD because the timely development of PD from ET substantiated the diagnosis of PD8. These durations adequately safeguard each diagnosis, so disease-specific homogeneity was maintained for these analyses. Unlike epidemiological studies, ET and PD patients with pre-existing ET were also substantiated by presynaptic dopamine transporter imaging, rather than relying solely on clinical diagnosis. The influential roles of older age and disease duration in neurodegeneration were sub-analyzed and interpreted in this study.
A limitation of the study was that the comparison data for the general population was published prior to the start of the study. During the study time period, participants had follow-up exams every 1.5 years for an average of 5 years. The recovery time from the various treatments depends on many factors, especially the treatments themselves. The best source of information about your situation is your healthcare provider because they can consider all the factors and give you information that’s relevant to your specific case and circumstances.
They can tell you what to watch for and what you need to do to take care of yourself if such problems occur. A trained, qualified healthcare provider should be the one to diagnose and treat essential tremor. Essential tremor isn’t life-threatening or dangerous, but tremors can also be a part of other conditions, some of which are treatable if caught quickly. It’s important to call your healthcare provider and make an appointment if you start experiencing tremors that you can’t explain. The possible complications and side effects of treatments for essential tremor depend on many factors, including the treatments themselves.
The baseline peripheral noradrenergic integrity was less affected in PDconv, but its denervation progressed more rapidly, catching up with the denervated myocardium seen in pure PD after approximately six years. The milder impairment observed in PDconv patients indicated a lesser burden shaped by its development from ET, while its faster deterioration hinted at the transfer of influential pathobiology from ET to PD. A previous study asserted that PD patients suffered abrupt vulnerability five years after diagnosis due to nonlinear deterioration26. The progression in PDconv patients of our study appears to lag by one year compared to that of the previous report.