It’s not Parkinson’s, it’s essential tremor: how to treat the condition – 08/10/2023 – Health

Often, aging is associated with the emergence of different pathologies. Diseases like essential tremor, however, are not linked to old age.

The most frequent disease among all movement disorders, essential tremor affects 6% of people over 60 years of age, but it can manifest itself from youth.

Many patients say they have lived with the disease for many years and claim that it gets worse with age, to the point of affecting daily activities.

Essential tremor is not a neurodegenerative disease, but is caused by a dysfunction of neural circuits linked to movement.

It is common for it to manifest itself in more than one person in the same family.

It is usually noticed during manual activities and can be more pronounced in one hand.

If the tremor is severe, the patient may have difficulty performing everyday tasks such as writing, holding a glass of water without spilling it, using cutlery, brushing teeth, putting on makeup, shaving, closing buttons or zippers, putting on earrings, etc.

Some people may also experience tremors in their voice or head.

It is, therefore, a pathology that can have a significant impact on quality of life. That’s why it’s important to seek personalized treatment for the problem.

uncertain origin

The tremor arises with the malfunction of neurons located in the thalamus, in a part of the brain linked to movement.

In these neurons, the pattern necessary for correct movement is replaced by an oscillatory activity that imposes itself on the entire motor circuit.

This causes the hands to shake at the same frequency as the oscillatory activity of these neurons when the person moves.

Although it is not known for sure what triggers the disease, studies relate it to a dysfunction of the cerebellum linked to neural activity in a region of the thalamus.

It is, therefore, different from other pathologies that produce tremors, such as degenerative diseases such as Parkinson’s.

In this disease, the tremor —which usually occurs at rest— results from the progressive death of neurons that produce dopamine, a neurotransmitter responsible for modulating the motor circuit and normal movement.

In addition to tremor, Parkinson’s patients suffer from other disorders such as dizziness and stiffness.

HIFU: treatment allows tremor control

When a patient has essential tremor, the doctors’ goal is to get their motor circuits working normally again.

Thus, the treatments aim to restore the activity pattern of the neurons so that the execution of the movement is correct.

The most traditional treatments against this pathology use beta blockers and antiepileptics.

But its use is generally not enough to improve the patient’s quality of life.

Fortunately, patients can resort to the HIFU system, a high-intensity ultrasound device that allows reaching the affected neurons in a controlled manner and without open cranial surgery.

The method is ideal for many patients as it is minimally invasive.

The patient needs to have his hair shaved in order for the MRI device to be attached.

After you lie down on the MRI table, a membrane through which very cold water circulates is also applied to your head to cool your scalp and prevent the ultrasound from overheating your skin.

The patient stays awake all the time, collaborating with the professionals during the intervention.

The ultrasound targets the spot in the brain where the neurons that doctors want to eliminate are located. The emitted energy is transformed into heat to heat the tissue in the target area.

As the temperature rises, the shivering progressively disappears, confirming that doctors are targeting the correct location.

The power of the energy is then increased in order to reach a temperature that causes irreversible damage to the neurons, resulting in a definite improvement in the tremor.

immediate benefit

One of the biggest advantages of this procedure is that the improvement of the tremor usually happens immediately.

Taking into account that the patient does not need previous hospitalization, he can be discharged 24 hours after performing the HIFU.

As with any treatment, some side effects may appear.

They are usually linked to the appearance of edema around the injured area, something that resolves in a short time.

Thus, the patient usually presents a high degree of satisfaction after the intervention.

*María Cruz Rodríguez Oroz is Director of the Department of Neurology at the University of Navarra, Spain

*This article originally appeared on The Conversation scholarly news site and is republished under a Creative Commons license. Read here the original spanish version