Trembling hands do not always indicate Parkinson's

For trembling hands, essential tremor is easily mistaken for Parkinson's

05/02/2014

When the hands shake again and again, sufferers and relatives usually think directly of Parkinson's. However, many people are not aware that a so-called essential tremor, which can be treated well with medication, is often behind the symptoms. Dr. Curt Beil from the Professional Association of German Neurologists (BDN) to the news agency „dpa“ out. Those affected should have the shaking checked out by a doctor to rule out other serious illnesses.

In the case of the essential tremor, the hands shake more than in Parkinson's
While the development of Parkinson's is usually associated with a lack of dopamine in the brain, but also with increased contact with pesticides - in France, the disease is recognized as an occupational disease of farmers since 2012 - is still unknown, which factors favor the essential tremor. The tremor is relatively harmless compared to Parkinson's and can be treated well with medication, explains Beil. However, the treatment of essential tremor is limited to alleviating the symptoms, a cure is currently not possible. The neurologist and psychiatrist advises to have the shaking checked out by a doctor to rule out serious illnesses.

Hand shaking is different in the essential tremor of Parkinson's disease in that it usually affects both hands or legs and does not begin one-sidedly as in shaking palsy, on the other hand, it is also more common. While in Parkinson's patients, four to six movements per second occur, in people with the essential tremor six to twelve movements per second. Another difference relates to the time of occurrence: In Parkinson's shaking is usually at rest, with tremor patients when holding objects or when the person stretches out his hands.

Trembling occurs in the essential tremor increasingly in action
The essential tremor can occur at any age, most often in the second and sixth decades of life. With the progression of the disease, the tremor frequency may decrease, but the amount of tremor often increases. The tremor can also occur due to stress. Therefore, tremor patients are advised to do relaxation exercises such as yoga or tai chi. In addition, should be dispensed with caffeine and alcohol, as well as the trembling is favored. Alcohol may help to alleviate the symptoms, but it will be more violent the next day.

According to Beil it is particularly difficult for those affected, that the tremors can affect outsiders such as fear or alcohol dependence. Some tremor patients would therefore withdraw and isolate themselves from society. However, the expert advises to deal with the disease openly.

Trembling hands can have many causes
If trembling hands first appear, sufferers should consult a doctor and have the cause clarified. Although in many cases it is based on the essential tremor, other diseases such as epilepsy, multiple sclerosis or diseases of the nervous system such as polyneuropathy can cause trembling. In addition, there are other possible causes such as hypoglycaemia, drug side effects or hyperthyroidism.

In order to find the underlying disease and to exclude others usually a complex differential diagnosis is necessary. The doctor first records the appearance, localization and strength of the tremor. At the same time, further investigations on neurological abnormalities are taking place. The patient's medical history is also included in the diagnosis. If it is an essential tremor, a drug therapy begins. (Ag)