What is a tremor?
Tremor is an involuntary, rhythmic movement in the muscles that can be symptomatic of another condition or medication. The majority of tremors affect the hands, but may also affect the head, face, voice, torso, arms or legs.
The most common cause of tremor is an inherited disorder known by several names, including:
- Essential tremor
- Familial essential tremor (inherited)
- Benign essential tremor
What is Parkinson’s disease?
Parkinson’s disease (PD) is a neurodegenerative disorder in which the deterioration of nerve cells in a particular part of the brain causes a deficiency of dopamine levels. Dopamine is a neurotransmitter that allows communication between the nerve cells that control motor function. The death of these cells that produce dopamine results in the motor symptoms associated with the disease, most notably tremors.
What causes Parkinson’s disease?
Several factors may play a role in developing PD, including:
- Certain genetic mutations
- Development of Lewy bodies (an abnormal cluster of protein) within brain cells
- Exposure to certain environmental toxins
What are the symptoms of Parkinson’s disease?
In addition to tremors, other signs and symptoms of PD may include:
- Slowed movement over time (bradykinesia)
- Development of rigid or stiff muscles
- Decreased ability to perform automatic movements (e.g., blinking, smiling)
- Tingling or numbness sensation (paresthesia)
- Changes in speech (hypophonia) or writing ability (micrographia)
How is Parkinson’s disease diagnosed?
If there is a suspicion of PD, a neurologist will perform a comprehensive physical examination and take a medical history, including an account of medications to rule out side effects that may mimic the symptoms of PD. Scans such as magnetic resonance imaging (MRI) may also be used to check for any structural abnormalities.
In addition, a neurological examination testing agility, muscle tone, gait and balance will be conducted. The results are then recorded in a table known as the United Parkinson’s Disease Rating Scale (UPDRS). This universal scale helps physicians document the progression of PD and establish a timeline of symptoms. Changes can be noted through the chart at follow-up visits.
How is Parkinson’s disease treated?
Patients usually respond well to medication for a long time. However, when the medication loses its efficacy, patients may then benefit from deep brain stimulation (DBS). DBS therapy involves the implantation of a battery-operated medical device (known as a neurostimulator) that delivers electrical stimulation to specific areas of the brain in order to improve movement.
DBS does not damage healthy brain tissue and is only an option when all other treatment modalities (e.g., medication, exercise) have failed.