Essential Tremor: More Prevalent Than Parkinson’s but Often Misdiagnosed

Howard Kane was in his late forties when he first noticed it. His hands trembled slightly whenever he picked up and held something. Toothbrush, razor, beverage glass, pen – anything that required movement from his hands would trigger the shaking. He thought he might have Parkinson’s disease, a disorder of the progressive nervous system that affects movement. It turned out Mr. Kane had something else, a disease that’s lesser known but far more common: Essential Tremor.

According to the National Institute of Neurological Disorders, 10 million Americans suffer from Essential Tremor, or ET – eight times as many as those who have Parkinson’s disease. ET causes shaking of the hands, head and voice, and can have profound impacts on one’s quality of life. Its victims aren’t just the elderly. Although it’s more common among those age 60 and older, middle-aged people can develop it, too, just as Mr. Kane did.

“In a medical context, ‘Essential’ refers to a symptom thatis isolated and doesn’t appear to have a specific underlying cause,” says JustinSporrer, M.D., a neurosurgeon with MiamiNeuroscience Institute, part of Baptist Health. “With Essential Tremor, weknow what the symptoms are and how they differ from Parkinson’s disease, but wehaven’t yet been able to pinpoint the cause.”

ET may be genetic – Mr. Kane says his mother, aunt andgrandmother had it – yet many patients have no family history at all. ET is sometimesmisdiagnosed as Parkinson’s disease, according to Dr. Sporrer. But while peoplewith Parkinson’s experience tremors even when their bodies are at rest(“resting tremor”), those with ET get them only when moving their hands andlegs, he says. ET can also affect the head, neck, voice box and the internaltorso in some instances.

Researchers have yet to find a cure for ET but its symptomscan sometimes be managed with medications, according to Dr. Sporrer. Anothertherapy, used mostly for Parkinson’s patients, is Deep Brain Stimulation (DBS).“With DBS, we implant an electrode in the brain that is controlled by a smallseparate device in the chest, and that helps reduce the frequency, intensityand duration of tremors,” Dr. Sporer says. “However, this therapy isn’t anoption for everyone.”

Mr. Kane, now retired at 72 after a successful careerspanning business, finance and corporate law, has had 25 years of practicelearning to live with the disorder.

“I consider my ET to be relatively mild compared to manyothers who have more significant disability,” says Mr. Kane, who is still ableto drive and, until the coronavirus pandemic put an end to the popular program,served as a therapy dog volunteer with his nine-year-old Labradoodle, Jazzy, atMiami Cancer Institute. “I’ve had to make adjustments – buttoning buttons iscertainly a challenge and writing a legible signature is all but impossible –but otherwise there’s very little I can’t do.”

For many people with more difficult ET disabilities,however, daily activities such as eating, drinking and grooming becomedifficult if not impossible. Because its effects can be so noticeable at times,people with ET can experience feelings of frustration and embarrassment. ManyET patients prefer not to go out in public at all, instead staying isolated intheir homes, which can trigger depression in some.

Mr. Kane knows to order soup not in a bowl but in a cupthat’s easier for him to hold, and he finds the heavier the spoon the better.He shaves with an electric razor, not a blade, he knows thicker pens are easierto write with, and he uses voice recognition software on his computer.

So what can’t he do? “No screwdriver jobs or changinglightbulbs,” Mr. Kane says with a chuckle. “No paring an apple or carving theThanksgiving turkey. And, much to my wife’s disappointment, no putting away thedishes.”

Miami Neuroscience Institute offers a number of different treatment options for people suffering with ET, including DBS and high intensity focused ultrasound. To learn more about our treatment options, click here. If you think you or a family member may have Essential Tremor, Parkinson’s disease or any other type of neurological disorder, you can make an appointment by calling 305-271-6159 or visiting BaptistHealth.net/Neuroscience.