Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Essential Tremor Debilitating and Misunderstood

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Essential Tremor Debilitating and Misunderstood

Article excerpt

Betty Schofield tripped a lot and couldn't even write her own name because of involuntary, rhythmic shaking movements in her muscles. Over three or four years the condition got progressively worse.

"One day I served my husband dinner that just flew across the floor," said Mrs. Schofield, 69, a retired jewelry store clerk who lives in the little Cambria County town of Sidman.

After an incorrect diagnosis of Parkinson's disease, multiple medications that didn't work and many tests, her problem was finally diagnosed by neurosurgeon Donald Whiting at Allegheny General Hospital's Center for Spasticity and Movement Disorders as essential tremor.

Never heard of it?

Neither have most people, although nearly 10 million Americans suffer from it, according to the International Essential Tremor Foundation.

"It's a misunderstood disease," said Susan Baser, a neurologist who serves with Dr. Whiting as a co-director of the Allegheny General center. "It starts off mild, then gets worse. Some people get it mild; some people get it worse. ... Since it responds to alcohol, some people self-medicate. Some people make the mistaken assumption [all sufferers] drink, and they're embarrassed.

"It's way under-treated. It's an under-recognized disability."

The neurological disorder, the most common type of numerous tremors, is more likely to be noticed in the hands, the National Library of Medicine's PubMed says. But it also may affect the arms, head, eyelids or other muscles -- even the legs and voice. The tremors tend to occur during activities.

With Parkinson's, patients get a combination of symptoms: a tremor when muscles are at rest, rigidity, slowness and loss of balance, doctors said.

Essential tremor, which includes an inherited variety known as familial tremor, is not life-threatening, but it can be disabling. Some people become recluses rather than let others see the tremors. At best, essential tremor is an embarrassment.

And, though there are treatments of varying effectiveness, there is no cure. Many sufferers just learn to live with it.

Mrs. Schofield got help good enough to prevent her having to live with it three-plus years ago, when Dr. Whiting did a procedure called deep brain stimulation. In DBS, as it's called, a battery- operated device is implanted to deliver electrical pulses to targeted areas of the brain that control movement, temporarily blocking the nerve signals that cause the tremors.

"My quality of life is wonderful," Mrs. Schofield said. "I'm 69, and I'm tap dancing now."

Deep brain stimulation is the extreme end of an essential tremor treatment continuum, said Patricia Jozefczyk, a neurologist, director of AGH's Botulinum Toxin Treatment Center and part of the Center for Spasticity and Movement Disorders.

"We start with medications, oral medications, and see what success we get," Dr. …

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