Shaking: an annoyance or Parkinson’s disease?

It’s fair to say, these are shaky times! In keeping with the rocky ride of 2020, have you noticed your hands shaking lately? Are you having trouble tying your shoes or signing your name, or are you embarrassed that the glass your holding is shaking? You think of those suffering from Parkinson’s disease. And you wonder if you are experiencing first signs of this trouble.

Parents may also have concerns if their child has shaky hand movements. A report from the University of California says that a condition called essential tremour can occur in young children and young adults. This problem increases with age. At around age 60, about five per cent of people notice a slight tremour. Another study states that about one per cent of the population suffers from tremour.

Essential tremour is the most common form and usually involves the hands and arms, less often other parts of the body.

It occurs with movement, not at rest.

This slight shaking can also affect the head, with movement from side to side, or up and down. On rare occasions, it involves the vocal cords, and the voice becomes halting. It may also be associated with poor balance.

No one is certain of the cause. Researchers are studying a part of the brain called the cerebellum which plays a role in movement and muscle control.

Doctors can usually make the diagnosis when symptoms have been present for at least three years and no other signs of neurological disease are evident. But there are differences between essential tremor and Parkinson’s disease that help doctors to distinguish one from the other.

For instance, considering statistical chances is helpful. Essential tremour is approximately eight times more common than Parkinson’s disease.

Essential tremour normally occurs during action, such as writing, eating or extending an arm to shake hands.

But in Parkinson’s disease, the tremour occurs when the arm is not being moved. This is a “resting tremour.”

There’s a difference in the tremour’s frequency and the magnitude. For essential tremour, it’s usually of higher frequency, with more repetitions over a length of time. In Parkinson’s disease, the frequency of movement is slower.

A look to relatives may provide clues. A family history of essential tremour exists in more than 50 per cent of cases, whereas in Parkinson’s disease, only 10-20 per cent.

In terms of symptoms, in essential tremour, the primary issue is anxiety regarding the shakiness. In Parkinson’s, other symptoms appear apart from the tremour, such as rigidity, slowed movements and balance issues.

Treatment of the two is different as well. The majority of people who have essential tremour do not require treatment. In fact, researchers report that those with this condition rarely bother to seek treatment. Or they wait for many years before seeing a doctor.

A change in lifestyle may ease mild tremours. Since sleep deprivation aggravates tremours, the answer is to get more shuteye.

There is little doubt that anxiety plays a major role with tremour. Sufferers indicate they try to avoid stressful activities such as public speaking due to the visibility of hand tremours. Yoga, stretching and relaxation exercises can be beneficial. Alcohol also has a moderating effect on tremor as long as used in moderation. Smoking must be eliminated as nicotine aggravates tremour.

For patients with Parkinson’s disease, alcohol has no effect on the disease. But drugs such as levodopa usually provide some improvement of symptoms.

And for parents who notice a child with shaky hands, have a doctor follow the case and keep a journal of what you see. As the child grows and becomes selfconscious of tremours, help them gain confidence through understanding of essential tremour.

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