Is It Parkinson's Disease or Essential Tremor?

I attended a Parkinson's meeting when a member of the audience with a shaky head and quivering voice like Katharine Hepburn's asked a question as to why her Parkinson's medications weren't working. I've wondered about the possibility of an incorrect diagnosis.

There are numerous tremor disorders, but the two most common ones are Parkinson’s Disease (PD) and Essential Tremor (ET). It is often difficult to distinguish between the tremor of PD and ET. To further complicate matters, around 30% of the patients with Parkinson’s don’t have a tremor.

If you experience an undiagnosed tremor or are concerned that you might be misdiagnosed, seek out the opinion of a Movement Disorder Specialist for the correct diagnosis and treatment.

The following table summarizes some of the differences between the tremor of PD and ET:

	Parkinson’s Disease (PD)	Essential Tremor (ET)
Symptoms	Those with Parkinson’s will exhibit SOME of the following symptoms: Tremor Rigidity and stiffness of muscles (e.g., stooped posture) Slowness of movement Poor balance and tendency to fall Shuffle (walk in small steps) Numerous non-motor symptoms	Tremor is the only symptom
When Tremors Occur	Resting tremor (when hands are at sides or resting in lap)	Activity tremor (when hands are in use)
Parts of Body Affected	Arms and hands are most prominent Usually NOT the head or voice	Hands Head (e.g., yes-yes or no-no tremors) Voice (causing a shaking or quivering sound)
Responsive to L-Dopa (Sinemet)	Usually yes	No

For further information:

Mayo Clinic.com at:  http://www.mayoclinic.com/health/essential-tremor/DS00367/DSECTION=symptoms

Comments

[Irene Ryden]

I was diagnosed with Parkinson's disease after having a SPECT scan but it is essential tremor I have with my hand when active and none when resting. Could this be a wrong diagnosis? my handwriting has also deteriorated

[Kate Kelsall]

Hi Irene,

Thanks for your comment.

From my personal observation and reading as a non-medical person, this is what I've learned:

Some people have both PD and ET.
Those with PD generally respond to Sinemet.
Those with ET generally don't respond to Sinemet.
Those with ET generally find that a little alcohol reduces their tremor, while those with PD find that alcohol does not reduce their tremor.
For those with a tremor: those with PD generally have a resting tremor while those with ET generally have an active tremor.
I've observed difficulty with handwriting from those with PD and ET. I've observed those with ET having such difficulty with handwriting that someone would have to hold their hands down when handwriting.
Those with ET have tremor as their primary symptom, while those with PD usually have several of the following 4 symptoms: shakiness, stiffness, slowness, and steadiness problems (I call them the 4 S Symptoms).

I hope this clarifies some of the differences. I would suggest obtaining an appointment with a Movement Disorder Specialist if you aren't already seeing one.

Good luck,
Kate

[Irene Ryden]

Thank you Kate, I will make an appointment with a Movement Disorder Specialist as I haven't seen one yet

[online xanax]

It is very difficult to treat Parkinson's... My father has it

[Larry Dedeaux]

Hi Katie, I have a tremor in both hands since I was a teenager, but in the last two years that tremor is begining to affect one side at rest. This tremor is a slower tremor where my thumb rubs my index finger. This is nothing that I see in Michael J Fox or Ali. The affected side, my arm is not swinging as much it use to. Could a person have both ET and PD?

[dree man]

Benign Essential Tremor is basically a disorder of the nervous system in which a patient experiences rhythmic shaking and it can affect any part of your body. In this sort of disorder the shaking usually occurs in the hands therefore it is known as the tremor of hands. It gets very difficult to perform even the easiest routine tasks like drinking water, eating, driving, writing, shaving or other activities that involve major participation of your hands. It is not a very hazardous medical condition but it does get worse with time therefore needs immediate medical supervision so that the disaster can be avoided.