Tremors: Could They Be Primary Essential Tremor?

Q: Tremors: Could They Be Primary Essential Tremor?

Hello： Based on your inquiry, in addition to primary tremor, physiological tremor may also be a possible cause. <br>A consultation with a neurologist can help clarify the situation. <br>If it does not affect your daily life, there is generally no need for excessive concern.

The body may tremble?

My symptoms are as follows: 1.
My hands tremble.
I've had this for a long time (since around middle school).
When I lift a cup to drink, my hands shake, and my head shakes as well.
When typing or using the mouse, both hands tremble, with my left hand shaking more than my right.
When I try to pay for something and hold coins in my left hand, it shakes.
If I place my left hand on the table and extend my index finger, it shakes quite noticeably.
2.
My legs tremble.
When I sit in a chair with my legs hanging, they shake.
When I lie in bed with my legs elevated, they also shake.
Going down stairs, my legs tremble (especially when moving slowly).
3.
My body shakes as well.
When I lie in bed and try to get up, during the process of sitting up from a supine position (like a sit-up), my neck, chest, abdomen, and legs all tremble (if I keep my hands still and do not support myself, the shaking is quite pronounced).
I do not feel any discomfort in my body; I can run and move.
Currently, these symptoms do not affect my daily life.
I haven't noticed any changes in the tremors recently.
I have made an appointment with a neurologist.
Doctor, could these symptoms possibly be indicative of essential tremor?

ken, 10~19 year old female. Ask Date: 2017/04/25

Dr. Hong Weibin reply Neurology

Hello: Based on your inquiry, in addition to primary tremor, physiological tremor may also be a possible cause.
A consultation with a neurologist can help clarify the situation.
If it does not affect your daily life, there is generally no need for excessive concern.

Reply Date: 2017/04/25

More Info

Understanding tremors can be quite complex, as they can arise from various underlying conditions. Based on the symptoms you've described, it is possible that you may be experiencing Primary Essential Tremor (PET), but a thorough evaluation by a neurologist is essential for an accurate diagnosis.

What is Primary Essential Tremor?
Primary Essential Tremor is a neurological disorder characterized by involuntary, rhythmic shaking, most commonly affecting the hands, but it can also involve the head, voice, and other parts of the body. It is often confused with other types of tremors, such as those caused by Parkinson's disease, but essential tremor typically occurs during voluntary movements, such as reaching for an object or writing, rather than at rest.

Symptoms You Described:
1. Hand Tremors: The tremors you experience while drinking water, using a keyboard, or handling coins are indicative of essential tremor. The fact that your left hand shakes more than your right could suggest asymmetry, which is common in essential tremor.

2. Leg Tremors: The shaking of your legs when sitting or lying down is less typical for essential tremor, as it usually affects the upper body more. However, some individuals with essential tremor can experience leg tremors, especially during specific postures or movements.

3. Body Tremors: The tremors you feel when transitioning from lying down to sitting up could be related to muscle activation and the effort involved in the movement. This phenomenon can occur in various conditions, including essential tremor.

Other Considerations:
While your symptoms align with essential tremor, it is crucial to rule out other potential causes of tremors, such as:
- Parkinson's Disease: This condition typically presents with resting tremors, stiffness, and bradykinesia (slowness of movement). Essential tremor usually does not have these resting tremors.

- Anxiety or Stress: Sometimes, tremors can be exacerbated by anxiety or stress, leading to a temporary increase in tremor severity.

- Medication Side Effects: Certain medications can cause tremors as a side effect. If you are taking any medications, it would be worth discussing this with your healthcare provider.

- Metabolic or Endocrine Disorders: Conditions such as hyperthyroidism can lead to tremors as well.

Next Steps:
Since you have already scheduled an appointment with a neurologist, this is an excellent step towards understanding your condition better. During your visit, the neurologist will likely perform a detailed neurological examination, review your medical history, and may order additional tests, such as blood tests or imaging studies, to rule out other conditions.

Management of Essential Tremor:
If diagnosed with essential tremor, treatment options may include:
- Medications: Beta-blockers (like propranolol) and anticonvulsants (like primidone) are commonly used to help reduce tremor severity.

- Lifestyle Modifications: Reducing caffeine intake, using weighted utensils, and employing relaxation techniques can help manage symptoms.

- Physical Therapy: Engaging in physical therapy may help improve coordination and muscle control.

- Surgical Options: In severe cases where tremors significantly impact daily life, surgical interventions such as deep brain stimulation may be considered.

In conclusion, while your symptoms may suggest Primary Essential Tremor, only a qualified healthcare professional can provide a definitive diagnosis. It is essential to communicate all your symptoms clearly during your appointment to ensure a comprehensive evaluation. Remember, managing tremors effectively often involves a combination of medical treatment and lifestyle adjustments.

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