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Symptoms of Essential Tremor in the hands

Essential Tremors – a Rare disease

I sat and watched him. The once fierce man who was now a mere fraction of the man I married. He was trembling, his dominant right hand and arm worse than the other. Initially I thought it is due to all the different medications he was on after he had his first heart attack. He thought the same and just tried to cope and still do what he could to lead a normal life.

He was trying to make coffee but could not get the water inside the mugs. Warm water spilled all over the counter. The mugs flew in all directions and ended shattered on the floor. His look of utter disbelief while still clutching the vibrating kettle shattered my heart.

I rushed to help him pick up the pieces. Finally we realized that there is more to his trembling and shaking than mere tiredness and depression. He was defeated and ended helplessly on the couch. Crying he asked what next. I could not answer as our lives were already in shambles due to his medical problems.

We did not bargain on him having a heart attack at 42. Who does? He did not have a family history of heart problems. He was overweight with a stressful job and smoking too much. Other than that he was healthy. Since the heart attack everything just went downhill.

Receiving a dreaded Diagnosis - Parkinson's Disease

The next day we ended in utter disbelief. Our local GP diagnosed him with Parkinsons and gave him medication. We got home and he was inconsolable. He asked what next. He was left with 40% heart function, diagnosed with Diabetes 2, hurt his back and neck at work and then diagnosed with trigeminal neuralgia TN (Face pain) and now this.

The tablets helped a little bit, but with everything else that was going on it was just another nail in his coffin. He fell back into depression for losing the way of life he had. For going from being able to help himself to someone who had nothing left to live. The days winded into another while desperately trying to cope and deal with the new diagnosis. We researched it on the internet and wondered what would be next.

Every day was different. A good day was when he could make coffee and take a shower all by himself. We tried to enjoy the good days knowing that they won’t last. After 6 months he was finally referred to a neurosurgeon who specialized in movement disorders. 

Seeing a Movement Disorder Specialist for a proper diagnosis

We were not sure what to expect when we finally had an appointment. The neurosurgeon took one look at him and said that he does not show the typical parkinsons symptoms. She also saw him for his Trigeminal neuralgia. As both parkinsons and trigeminal neuralgia are brain disorders she send him for a MRI. She was not happy that they did not take the medication away a week before our visit to ensure a proper diagnosis.

Tests for Essential Tremors

She asked him to walk in a line, then draw a spiral and did a smell test. She also had him lift his arms up and move and then sit quietly. The TN made it difficult for him to speak so I learned to watch him and tried talking for him, but she wanted to see what happens when he speaks and his movements. 

Spiral test showing difference between Parkinson's, Essential Tremor and Dystonic Tremors
Spiral test showing difference between Parkinson's, Essential Tremor and Dystonic Tremors

The spiral test showed that it is essential tremor and not Parkinson. Someone with essential tremor cannot draw a smooth spiral as seen above. In Parkinson the smell is also affected but not in ET. Because Parkinson’ affect the muscles there is a rigidity and can be seen when a person walks. They tend to give small steps. Essential tremors worsens with actions or tasks whereas Parkinson’s tremor is also at rest. 

The relationship between Parkinsons and Essential Tremors
Published in Parkinsonism & related disorders 2016 - The relationship between essential tremor and Parkinson's disease. M. A. Thenganatt, J. Jankovic

I never thought we would be happy in receiving a diagnosis, but there is a major difference between Parkinson’s and Essential Tremors as can be seen above. Currently there is no cure for either of the two diseases. 

Now we had a diagnosis and new medication, but we have to learn to cope with it. There are good days and then there are bad days. It is trial and error to see what helps. The ridicule from people are bad and he is embarrassed. Unfortunately the higher his stress levels are, the worse the tremors become. When he is tired it increases. This also isolates him as he tends to rather hide than face the world. A vicious cycle that we are trying to break.

Essential Tremors Awareness

To bring awareness to Essential Tremors I have designed a T-shirt with the words “No I am not drunk, I have a disease called Essential Tremors”. It is available internationally on Teespring and in South Africa at OTC Printing. The words was chosen as so many times he was asked if he is drunk.

No I am not drunk, I have a disease Essential Tremors
Teespring - International
No I am not drunk I have a disease Essential Tremors
OTC Shop - South Africa

More information on Essential Tremors and Parkinson's

For more information on Essential Tremors visit the International Essential Tremor Foundation and for Parkinson’s the Parkinson Foundation.

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