Essential Tremor vs. Parkinson’s


Different diseases present with different symptoms, which can be helpful when trying to diagnose. But sometimes the same symptoms will be present in two different diseases. This is the case when we talk about essential tremor vs Parkinson’s disease.

Parkinson’s disease and essential tremor are not the same, nor is essential tremor a form of Parkinson’s. While essential tremor is a nervous system disorder, Parkinson’s disease is a neurodegenerative disease that affects the brain. 

Knowing the differences between the two makes it easier to describe the conditions to a doctor and increases the likelihood of getting the correct diagnosis. It will also help you decide between essential tremour or Parkinson’s home care services for you or a loved one. Read on to learn everything you need to know about essential tremor vs. Parkinson’s disease.

What Is Essential Tremor?

Essential tremor is a disorder of your nervous system. It causes involuntary rhythmic shaking called tremors. These tremors can occur anywhere in the body but they are most likely to occur in your hands. The condition in itself is not dangerous, but it does progress and the tremors tend to get worse with time.1

Symptoms

The tremors themselves are the main symptom of essential tremor. Some things to know about the nature of the tremors themselves when they occur as a result of essential tremor:

  • Essential tremor may begin gradually and can affect both sides of the body simultaneously.
  • The tremors tend to worsen with movement.
  • The tremors can get worse as a result of stress, fatigue, caffeine, or temperature.

Causes and Risk Factors

The exact cause of essential tremor is not currently known, but in about half of the cases of essential tremor a specific genetic mutation is seen. Other risk factors include:

  • Heredity – Essential tremor is more likely to occur if there is a family history of it.
  • Age – Essential tremor occurs most frequently in people over the age of 40.

What is Parkinson’s Disease?

Parkinson’s disease is a neurodegenerative disease that affects a specific area of your brain that is full of dopamine-producing neurons. What are the early warning signs of Parkinson’s? Like essential tremor, the disease progresses and worsens over time. While Parkinson’s itself is not fatal it can lead to complications that may affect daily life, lead people to need full-time care, or in some cases prove fatal.2

Symptoms

One of the main symptoms of Parkinson’s is also tremors and movement disorders. A Parkinsons tremor has slight differences from an essential tremor. In addition to tremors, other symptoms of Parkinson’s include:3

  • Slowed voluntary movement (bradykinesia), which makes it difficult to walk or perform daily activities
  • Stiff muscles that do not loosen up as the day progresses
  • Affected writing that turns your handwriting smaller or makes it more cramped
  • Stooped posture or difficulty maintaining balance
  • Changes in your speech may start with a quieting or lowing of your voice and progress to slurred, difficult-to-understand speech
  • Loss of automatic movements like smiling or blinking can lead to a masked face
  • Sense of smell may be lost

Causes and Risk Factors

Similar to essential tremor, the exact cause of Parkinson’s is not known. Although, some factors increase your risk of developing the disease:

  • Heredity – Your risk of developing Parkinson’s is slightly higher if you have a close relative who has developed the disease
  • Age – The older you are, the higher your risk. Most cases of Parkinson’s develop in people over the age of 60
  • Sex – While Parkinson’s can occur in anyone, studies have shown that it tends to occur more often in men than in women.
  • Environmental factors – There is a higher risk associated with people who have had persistent exposure to certain pesticides and herbicides

Differences Between Essential Tremor and Parkinson’s

While essential tremor and Parkinson’s are different conditions, it can be easy to get the two confused. Since the main symptom for each is tremors, it can be difficult even for a doctor to diagnose correctly.

However, there are some Parkinson’s symptoms that are not present in essential tremor. These differences include:4

  • Type of tremors – The tremors in essential tremor normally occur or get worse when the patient is moving. PD patients are more likely to notice tremors when they are at rest.
  • Location of tremors – Both conditions are likely to cause tremors in the hands, with the possibility of the voice and head also being affected. However, essential tremor is unlikely to cause tremors in the legs whereas Parkinson’s tremors may progress to the legs and other parts of the body.5
  • Frequency and amplitude of tremors – Essential tremor leads to movements that occur at a higher frequency than tremors that are a result of Parkinson’s. Conversely, Parkinson’s leads to tremors of greater amplitude than those that are a result of essential tremor.
  • Duration of tremors – People with essential tremor tend to have a greater duration of time experiencing tremors. It has been reported that the duration is up to three times higher than people having tremors from Parkinson’s.
  • Progression of tremors – Parkinson’s tremors will generally start on one side of the body. They may then progress to affect both sides. With essential tremor, both sides of the body are likely to be affected from the beginning.
  • Family history – The link to family history is stronger in people who have essential tremor. Around 50% of people who develop the essential tremor type will have a family history of the condition whereas that link drops to around 10 – 15% when looking at the family histories of those who develop Parkinson’s.

Diagnosing Essential Tremor vs. Parkinson’s

Diagnosing either of these conditions can be tricky. There is no simple test that can be done that will show if you have essential tremor or Parkinson’s. Your doctor will use a combination of techniques to diagnose your condition:6

  • Medical history – Your doctor will go over your full medical history including that of family members to identify any warning signs.
  • Physical exam – During your physical exam, your doctor may test your motor symptoms and motor skills. This may be able to help them distinguish between essential tremor and Parkinson’s.
  • Handwriting exam – Since Parkinson’s can make your handwriting look small and cramped, this can be an indicator as to which condition you have.
  • DaTScan – A dopamine transported scan can identify any changes in your dopamine levels. This won’t give any definite diagnosis, but taken with other factors it can help distinguish between essential tremor and Parkinson’s.
  • Imaging tests or MRI – These may be used to rule out other possibilities.
  • Ultrasound – Some promise has been shown for the idea that a transcranial sonography ultrasound can help differentiate between essential tremor and Parkinson’s, but this is still in the early stages of testing.

Since the two conditions present similarly, it can be difficult in the early stages to successfully diagnose them. This is where you can be a huge help in your diagnosis. The more specific you can be about your symptoms the better chance your doctor will have to successfully diagnose your condition and start you on the correct course of treatment.

Treatment

There is no cure for either essential tremor or Parkinson’s but the effects of both can be mitigated through treatment. There are many different avenues that you may need to take depending on the severity of your symptoms.

Medication

Medication can be used to treat both conditions. Although, the type of medication varies depending on which condition you have.

  • Essential tremor – Essential tremor is most likely to be treated using either propranolol, which is a beta-blocker, or primidone, which is an anticonvulsant. These can help reduce tremors by up to 50%.
  • Parkinson’s – Parkinson’s main medication is carbidopa/levodopa, although this medication may be combined with others including:
    • Dopamine agonists
    • Anticholinergics
    • COMT inhibitors
    • MAO-B inhibitor
    • Amantadine

These medications can help with managing symptoms, but their effectiveness does wane with time. A loss of effectiveness tends to occur somewhere between three and six years into treatment.

Therapy

Physical and occupational therapy can help with the management of symptoms. In the case of Parkinson’s, speech therapy may also be helpful for patients who are noticing their voices being affected by the disease. There are also coordination exercises for Parkinson’s patients that can help with strength and mobility. 

Surgery

For either condition, surgical procedures such as deep brain stimulation may be employed to help mitigate symptoms. However, surgery does come with risks and will likely only be tried if other courses of treatment are ineffective.

Alliance Homecare Helps You Manage Your Condition

Whether you’re dealing with essential tremor, Parkinson’s, or another condition, managing the changes to your daily life can be difficult. It helps to have the best support possible. 

At Alliance Homecare, we’re here to offer our support.

Our skilled caregivers are knowledgeable in numerous conditions and will work with you to create a personalized care plan best suited to provide you with the help you need. Accepting that you or a loved one needs in home nurse care can be difficult. At Alliance, we strive to create the easiest and most respectful environment possible to provide the Parkinson’s homecare support you need.

 

Sources: 

  1. Mayo Clinic. Essential Tremor. https://www.mayoclinic.org/diseases-conditions/essential-tremor/symptoms-causes/syc-20350534 
  2. Parkinson’s Foundation. What Is Parkinson’s? https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons 
  3. Mayo Clinic. Parkinson’s Disease. https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055 
  4. Healthline. Understanding the Difference Between Essential Tremor vs. Parkinson’s Disease. https://www.healthline.com/health/parkinsons-disease/essential-tremor-vs-parkinsons#differences 
  5. EssentialTremor.org. ET vs Parkinson’s disease. https://essentialtremor.org/wp-content/uploads/2013/07/ETvsPD092012.pdf 
  6. Cala Trio. Essential Tremor vs Parkinson’s Disease. https://calatrio.com/help-center/articles/4404038080795-essential-tremor-vs-parkinsons-disease/#diagnosing 

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