BENIGN ESSENTIAL TREMOR

TYPES

There are different types of BET based on the area of the body that is primarily affected. The most common type is the limb tremor, which affects the hands and arms. This type of tremor can make tasks such as writing, eating, or drinking difficult.

Another type of BET is the head tremor, which causes shaking or nodding of the head. This can affect a person’s ability to hold their head steady, leading to difficulties with activities such as reading or using a computer.

Some individuals may also experience voice tremors, which can cause a shaky or quivering voice. This can impact speech, making it difficult for others to understand what they are saying.

SYMPTOMS

The symptoms of Benign Essential Tremor (BET) can vary from person to person, but the most common symptom is involuntary shaking or tremors. These tremors typically occur during voluntary movements and can affect different parts of the body, including the hands, arms, head, voice, and even the legs.

The tremors associated with BET are often rhythmic and can range from mild to severe. They may worsen with certain activities or situations, such as stress, fatigue, or when attempting precise movements like holding a small object or writing.

Here are some specific symptoms commonly associated with BET:

1. Hand and arm tremors: Shaking of the hands and arms, which can make tasks like writing, using utensils, or holding objects challenging.

2. Head tremors: Involuntary nodding or shaking of the head, which can make it difficult to keep the head steady. This can affect activities like reading or using a computer.

3. Voice tremors: Shaky or quivering voice, making it challenging to speak clearly. This can impact communication and may lead to difficulties being understood by others.

4. Tremors in other body parts: Although less common, tremors can also affect other parts of the body, such as the legs. This can cause difficulties with balance and coordination.

6. Abnormal reflexes: Brachial plexus injuries can affect reflexes in the affected arm. Reflexes may be diminished, exaggerated, or absent.

DIAGNOSIS

The diagnosis of Benign Essential Tremor (BET) is primarily based on a thorough medical history, physical examination, and evaluation of the characteristic symptoms. Since BET is a clinical diagnosis, there is no specific test to definitively confirm its presence. However, healthcare professionals may use certain methods to rule out other potential causes of tremors and to support a diagnosis of BET.

During the evaluation, the healthcare professional may:

1. Review medical history: This involves discussing the patient’s symptoms, their duration and frequency, as well as any family history of tremors or other movement disorders.

2. Perform a physical examination: The healthcare professional will assess the presence and characteristics of tremors, observe their location and severity, and determine the impact on daily activities.

3. Conduct neurological examination: This helps to assess other neurological functions and rule out other conditions that may cause tremors, such as Parkinson’s disease or dystonia.

4. Order diagnostic tests: While there are no specific tests for BET, certain tests may be ordered to rule out other potential causes. These tests can include blood tests, imaging studies (such as MRI or CT scans), or specialized neurological tests if deemed necessary.

It’s worth noting that the diagnosis of BET can sometimes be challenging, as the symptoms can overlap with other conditions. In some cases, a healthcare professional may refer the patient to a neurologist, who specializes in diagnosing and treating neurological disorders, for further evaluation.

TREATMENT

The treatment of Benign Essential Tremor (BET) aims to manage and reduce the severity of tremors, improve quality of life, and minimize the impact of tremors on daily activities. While there is no cure for BET, there are several treatment options that can be considered based on the individual’s symptoms and their impact.

1. Medications: Medications are often the first line of treatment for BET. Beta blockers, such as propranolol, and anticonvulsants, such as primidone, are commonly prescribed to reduce tremors. These medications work by affecting the central nervous system and can help alleviate the severity of tremors in many individuals.

2. Botox injections: In some cases, Botox injections may be recommended, especially for focal hand tremors. Botox works by temporarily paralyzing the muscles responsible for tremors, reducing their movement and severity. The effects of Botox injections usually last for a few months and may require repeat treatments.

3. Occupational therapy: Occupational therapy can provide strategies and techniques to improve functionality and cope with tremors. Therapists may recommend adaptive devices, such as weighted utensils or writing aids, to assist with daily activities.

4. Deep brain stimulation (DBS): For individuals with severe tremors that are not responsive to medications or other treatments, deep brain stimulation may be considered. DBS involves surgically implanting electrodes into specific areas of the brain, which are then connected to a pulse generator. The generator delivers electrical impulses to help control tremors.