Not all tremors indicate Parkinson’s as various other disorders may cause shaking hence, understanding the differences helps in early diagnosis and proper management. Tremors or involuntary shaking movements are alarming, leading many to fear the worst which is Parkinson’s disease however, it is essential to understand that not all tremors are a sign of Parkinsonism.
In an interview with HT Lifestyle, Dr Shirish M Hastak, Regional Director of Neurology – Stroke and Neurocritical Care at Gleneagles Hospitals in Mumbai’s Parel, explained, “While Parkinson ’s-related tremors are well-known, various other conditions can also cause shaking, many of which are not serious or progressive. Seeking early medical consultation can help in proper diagnosis and treatment.”
Understanding tremors:
Dr Shirish M Hastak said, “Did you know? Tremors are involuntary, rhythmic muscle movements that can impact the parts of the body, mainly the hands, arms, legs, head, or voice. They may occur at rest, during movement, or while maintaining a posture. Tremors can be classified into different types, with Parkinson’s tremors being just one category among many. Not all tremors mean Parkinson’s disease so please check with your Physician or neurologist.”
Parkinson’s disease affects movement, causing symptoms such as tremors, stiffness, and slow movements. However, according to Dr Shirish M Hastak, various other conditions can lead to tremors –
• Essential Tremor (ET): It is often mistaken for Parkinsonism. It usually affects the hands, head, or voice and worsens with movement, unlike Parkinson’s tremor, which occurs more prominently at rest.
• Physiological Tremor: Everyone experiences this mild, barely noticeable tremor during exams which can be induced due to stress, fatigue, caffeine, or anxiety.
• Dystonic Tremor: Commonly seen in people with dystonia, a condition that causes involuntary muscle contractions, leading to abnormal movements.
• Conditions like thyroid disorders, liver or kidney disease and low blood sugar levels can also lead to shaking and tremors.
How to differentiate Parkinson’s tremor from other tremors?
Dr Shirish M Hastak answered, “Parkinson’s tremors improve with movement, whereas essential tremors worsen with movement. Parkinsonian tremors usually start on one side of the body and progress gradually. Other symptoms accompany Parkinson’s tremors, such as muscle stiffness, slowness of movement and balance problems.”
The diagnosis:
Dr Shirish M Hastak shared, “Neurological examination, MRI or CT scans to check for structural brain issues, Blood tests to examine thyroid, kidney and liver functions. Even Dopamine imaging scans (DaTscan) for detecting Parkinson’s disease can be advised to the patient if there is uncertainty about the clinical diagnosis.”
Treatment and management
Treatment depends on the underlying cause. Dr Shirish M Hastak, said, “For essential tremors, medications like beta-blockers or anticonvulsants can help. Lifestyle changes, stress management, and physical therapy can also be beneficial. In severe cases of essential tremors deep brain stimulation (DBS) may be considered. If tremors result from medication or metabolic disorders, addressing the root cause can often resolve the issue. With the appropriate approach, tremors can often be managed, allowing individuals to live without unnecessary fear or stress.”
Talking about how lesioning surgery is also beneficial for some selected patients, Dr Shirish M Hastak said, “This procedure stands out due to its immediate efficacy, affordability, and longevity. In patients who cannot, use a spoon or a glass due to severe tremors of the hand or the leg, this surgery can improve the quality of life. Lesioning surgery involves creating a small, controlled lesion in a highly targeted brain area.”
He concluded, “For patients who have struggled chronic symptoms of essential tremors for many years, the results are almost miraculous. Moreover, the reduced cost and shorter recovery time make it an accessible solution for many individuals who cannot afford deep brain stimulation. It represents a significant advancement in functional neurosurgery.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
