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At this time, there are no tests that can definitively diagnose either ET or PD and it is not uncommon to have the two mistaken for each other. The diagnosis is based on a complete medical/symptom, family and medication history and an examination by a physician, preferably a neurologist who specializes in movement disorders. Obtaining a handwriting sample may be helpful in making an accurate diagnosis; in ET handwriting is generally large and tremulous, whereas in PD, micrographia is common. An accurate diagnosis is critical as the treatment regimen is very different for the two disorders. Other treatments of ET include primidone, which also has Class A evidence to support its use in ET, or topiramate, gabapentin, alprazolam, clonazepam and other betablockers , which all have Class B evidence to support use for ET.
Can Parkinson’s be misdiagnosed as essential tremor?
Although the tremors of essential tremor and Parkinson's disease differ, there is some clinical overlap. As a result, essential tremor is frequently misdiagnosed as Parkinson's disease, and Parkinson's disease is frequently misdiagnosed as essential tremor (Jain et al., 2006).
Tremors occur mainly in the distal hands and are 4 to 12 Hz in frequency, but this can be widely variable. Tests such as those shown below are ways in which a physician can evaluate and monitor tremor. Essential tremor is a neurological disorder that causes involuntary , rhythmic shaking, or tremors. It occurs most often in people age 65 and older, although it can develop at any age. Essential tremor most commonly affects the hands, but it can occur in the head, face, voice box, arms or almost any part of the body.
Patient Handouts
More severe tremors, a lower sleep disorder frequency, and a similar prevalence of other non-motor symptoms also can occur. During DBS, the surgeon implants electrodes in the brain to deliver controlled electrical impulses that help control tremors. Learn more about deep brain stimulationfor essential tremor and other movement disorders. Propanolol blocks the stimulating action of neurotransmitters to calm your trembling. This beta blocker is effective in 40% to 50% of patients and is less useful in reducing head and voice tremor. It is usually avoided in patients with asthma, emphysema, congestive heart failure or heart block, and should be used with caution by people with diabetes who are on insulin.
Experts use gabapentin for short-term treatment of Essential Tremor affecting the hands, although it is not known how the drug works. It is important to start with a very low dose and slowly increase the dose to avoid sleepiness. Many patients may experience a feeling of mental dullness or drowsiness and should consult with their doctor about adjusting the dose. As many as 30% to 40% of people do not tolerate this drug in higher doses. Sodium oxybate is currently an approved medicine for narcolepsy in the United States and also used for intravenous anesthesia, ethanol withdrawal, and abstinence in Europe .
Physical therapy (occupational therapy)
These medications provide good benefit, reducing tremor amplitude in approximately 50–70% of patients. There are no tests that definitively test for either essential tremor or Parkinson’s disease, so the two are frequently confused. However, a neurologist alcohol and essential tremor should be able to accurately diagnose a patient based on their symptoms, family history, medication history and a comprehensive neurological exam. There are many different types of tremor, but essential tremor is the most common of the movement disorders.
