July 11, 2020 by Peter B. Laird
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 that is isolated and doesn’t appear to have a specific underlying cause,” says Justin Sporrer, M.D., a neurosurgeon with Miami Neuroscience Institute, part of Baptist Health. “With Essential Tremor, we know what the symptoms are and how they differ from Parkinson’s disease, but we haven’t yet been able to pinpoint the cause.”
ET may be genetic – Mr. Kane says his mother, aunt and grandmother had it – yet many patients have no family history at all. ET is sometimes misdiagnosed as Parkinson’s disease, according to Dr. Sporrer. But while people with Parkinson’s experience tremors even when their bodies are at rest (“resting tremor”), those with ET get them only when moving their hands and legs, he says. ET can also affect the head, neck, voice box and the internal torso in some instances.
Researchers have yet to find a cure for ET but its symptoms can sometimes be managed with medications, according to Dr. Sporrer. Another therapy, 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 small separate device in the chest, and that helps reduce the frequency, intensity and duration of tremors,” Dr. Sporer says. “However, this therapy isn’t an option for everyone.”
Mr. Kane, now retired at 72 after a successful career spanning business, finance and corporate law, has had 25 years of practice learning to live with the disorder.
“I consider my ET to be relatively mild compared to many others who have more significant disability,” says Mr. Kane, who is still able to 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, at Miami Cancer Institute. “I’ve had to make adjustments – buttoning buttons is certainly 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 become difficult if not impossible. Because its effects can be so noticeable at times, people with ET can experience feelings of frustration and embarrassment. Many ET patients prefer not to go out in public at all, instead staying isolated in their homes, which can trigger depression in some.
Mr. Kane knows to order soup not in a bowl but in a cup that’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 easier to write with, and he uses voice recognition software on his computer.
So what can’t he do? “No screwdriver jobs or changing lightbulbs,” Mr. Kane says with a chuckle. “No paring an apple or carving the Thanksgiving turkey. And, much to my wife’s disappointment, no putting away the dishes.”
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.