A Simple Guide to Benign Tremors, Diagnosis, Treatment and Related Conditions

This book describes Benign Tremors, Diagnosis and Treatment and Related Diseases

I have a patient who develops a mild tremor of his right hand.
The tremor becomes until he was unable to write with a pen or hold a cup.
He was seen by a neurologist who diagnosed him as having benign tremor.
Later he developed a headache which was caused by a small benign tumor of his brain.
This was diagnosed with a CT scan of his brain.
Even after the operation to remove his benign brain tumor relieved him of the headache, his right hand tremor remains without improvement.
This is benign or essential tremor.

Benign tremor (also called essential tremor) is an involuntary muscle movement, trembling, or shaking of the limbs.

It can affect almost any part of the body, but the trembling happens most often in the hands especially when the patient do simple tasks, such as drinking from a glass or tying shoelaces.

Benign tremor is normally not a serious disorder but it normally becomes worse over time and can be severe in some people.

Other disorders do not cause benign tremor, even though benign or essential tremor is occasionally confused with Parkinson's disease.

Benign tremor can happen at any age but is most frequent in people age 40 and older.

Tremor is the most frequent of all movement disorders, and benign tremor is the most common neurological cause of postural or action tremor.

It normally manifests as a bilateral postural 6 to 12 Hz tremor of the hands, accompanied by a active and resting component.

The upper limbs are often symmetrically affected, but with disease progression, the head and voice (less often legs, jaw, face, and trunk) may be affected.

Tremor most accurately indicates a small, rhythmic shaking movement that happens in a back-and-forth pattern.

Everyone has a small occasionally undetectable shake when they move their hands or legs known as physiological tremor.

Fatigue, stress, feelings of anger or fear, caffeine, and smoking can make this a physiological tremor more outstanding.

A tremor is a repetitive movement of a part of the body and is involuntary which is generally not controllable and happens without the patient deciding to move that body part.

It is often felt as a trembling or shaking sensation.

The word 'essential' means that there is no linked disease that produces the tremor.

It is different from physiological tremor

The tremors can become quite serious so that everyday activities like holding a cup can be difficult.

Benign tremor can happen at any age but often happens in middle-aged older men and women.

The only symptom present in benign or essential tremor is the mild shaking of the hands (tremor).

If the person has other symptoms then he or she may have a different disorder (shuffling of feet, rigidity of the arms, legs in Parkinson).

In benign or essential tremor, the tremor normally begins in one hand or arm.

In the space of 1-2 years, the other hand or arm tends to be affected.

Very occasionally, it may spread to involve the legs.

The voice, jaw or face may also be involved.

To evaluate the tremor itself, the doctor may ask the patient to:
Drink from a glass
Hold the arms outstretched
Write
Draw a spiral

Benign tremor does not need treatment if symptoms are mild and do not cause embarrassment

Propranolol and primidone are given initially for benign tremor

Surgical methods are:
Deep brain stimulation
Focused ultrasound, or
Gamma knife thalamotomy
Botulinum toxin injections

TABLE OF CONTENT
Introduction
Chapter 1 Benign Tremors
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Hyperthyroidism
Chapter 8 Parkinson Dis

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