Parkinsons Vs Essential Tremor

[whyishake]

Hi everyone: I’ve just recently been diagnosed with “early onset” Parkinsons. The Neurologist made his diagnosis based solely on my resting tremor and the exclusion of other problems, based on blood and physical tests he did. Anyhow, I’ve just discovered that all of my Mothers siblings have tremors, as well as their Mother. According to Mom, they are not Parkinsons. I’ve got a whole slew of questions but these are the major ones.

What’s the basis difference between Essential Tremors and Parkinsons?

Is it unknown for a family to have both Essential Tremors and Parkinsons

I’m going to get a second opinion on this but until them I’m taking Amantadine (100MG 2x/day).

If anyone can help me out with these questions, I would be very thankful.

Sincerely
Ken

[teaver]

http://www.clevelandclinicmeded.com/DISEASEMANAGEMENT/neurology/tremor/tremor.htm

http://www.tremoraction.org/pdfs/SEP_2005.pdf
Read the article POET Clinical Trial

[CarolynS]

Here is the content from the URL posted by teaver. I was originally dxd with ER in 1989 by a general practice neuro. Then in 1994, with PD by a movement disorder specialist.

It is my understand that the primary difference between PD and ET is the tremor. Especially early in the disease, tremor is more active with movement in ET; e.g. eating. In PD tremor is more active during resting; e.g. for me when sitting with absolutely nothing to do, like listening to a lecture, my tremor is at it's worse.

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Essential Tremor vs Parkinson's Disease

What is the difference between essential tremor and Parkinson’s disease?
Both essential tremor (ET) and Parkinson’s disease (PD) are movement disorders. A movement disorder can be defined as any disease or injury that interferes with an individual’s movement.

ET and PD are different disorders but are sometimes associated because they share many features.

The term "tremor" is used to describe involuntary shaking. Tremor can be caused by a multitude of different factors and diseases—including Parkinson’s disease, multiple sclerosis, fatigue after exercise, extreme emotional distress, brain tumors, some prescription drugs, metabolic abnormalities, and alcohol or drug withdrawal.

Essential tremor

Essential tremor is a neurological disorder characterized by tremors. Areas affected most often include the hands, arms, head, and sometimes the voice. Essential tremor does not affect life expectancy, but it can become disabling for many common activities, such as writing and eating. ET also does not increase the risk for Parkinson’s disease.

Symptoms of ET include:

* Involuntary tremors that occur for brief periods of time
* A shaking voice
* Nodding head
* Tremors that worsen during periods of emotional stress
* Tremors that get worse with purposeful movement
* Tremor lessens with rest
* Tremors are the only symptom
* Difficulty with balance (rare)

Parkinson’s disease (PD) is a chronic, progressive neurological disease that affects a small area of nerve cells (neurons) in an area of the brain near the neck, known as the substantia nigra. These cells normally produce dopamine, a chemical (neurotransmitter) that transmits signals between areas in the brain (specifically, these areas are called the substantia nigra and the corpus striatum). These signals, when working normally, coordinate smooth and balanced muscle movement.

Parkinson's disease, however, causes these neurons in the substantia nigra cells to die, leading to a lack of dopamine in the brain, especially in the part of the brain known as the basal ganglia. The basal ganglia are responsible for organizing movement commands from other parts of the brain. The loss of dopamine makes nerve cells fire out of control, causing patients to lose the ability to control their body movements' varying degrees of muscular control.

Symptoms of PD include:

* Muscle rigidity
* Tremors
* Bradykinesia (the slowing down of movement and the gradual loss of spontaneous activity)
* Changes in walking pattern and posture
* Changes in speech and handwriting
* Loss of balance and increased falls

[proudest_mama]

Ken,

I think sometimes you have that "gut" instinct and I'm curious if this is how you feel. (And in retrospect, I wonder how many others had that gut instinct).

All I can say is that I knew, without a doubt, that I had PD and not essential tremors.

Unlike you, however, I had multiple symptoms ... a resting tremor, stiffness in my hands so bad that I needed two hands just to brush my teeth, loss of arm swing, and loss of smell.

In the end, putting two and two together, it was the TREMOR which drove me absolutely bonkers. And, again, in retrospect, I realize that I did everything in my power not to be "idle" ... I wouldn't read a book, watch television, etc. because of that tremor. I found it so much easier to be the Energizer Bunny because, if I wasn't idle, I didn't notice the tremor as much.

Additionally, what upset me the most (and, as far as I know, I'm the only one who felt this way), was that when I initially woke up in the morning, my tremor was at rest, but when I engaged the brain, the tremor always materialized. Gosh how I hated to wake up!

Keep us informed, Ken, because we care. No strings attached. Whether or not you have PD, whether or not a loved one has PD, you will find the most compassionate, honest and even funny group of people in the world.

Terri

[whyishake]

ChuckSmith, Teaver, CarolynS, & Proudest Mama:

Thank you so much for taking the time to respond to my post; your abundant knowledge and caring are obvious in your responses. I’ve spent the last week doing my homework: lots of reading and a little soul searching.
This is what I’ve come up with:

PD and ET are elusive possibly connected disorders.

Both are degenerative and share many symptoms that differ from person to person.

Neither are curable but both may be controlled by numerous drugs.

ChuckSmith is right: With only a tremor, it’s way too early for a PD diagnosis. Couple early diagnosis with Proudest Mama’s idea of gut instinct and I think the Neurologist just might be wrong. However, I’m confident that the Neurologist did a good job at eliminating other possible conditions—with test results that my regular Doctor was smart enough to do. The POET clinical trial information that Teaver provided was very interesting and sounds promising but also sounds like it is still sometime in the future. CarolynS’s comments about being diagnosed by a movement disorder specialist spurred my investigation of that possibility. I’ve two excellent resources within a couple hours drive: Mayo Clinic in Rochester Minnesota and the Marshfield Clinic in Wisconsin.

So, this is my plan: Do nothing.

Well, almost nothing: Seeking a movement disorder specialist doesn’t make sense at this time, considering my having only one symptom (tremor) and no social or work related issues. If I have PD, time will tell. For two reasons, I will be keeping an appointment with the Neurologist on the 29th of Dec. First: so he can determine the effectiveness of the amantadine that I’m now taking 3X/day and what that may or may not mean and to discuss no drug treatment and the possible consequences.

Thanks again for your input.

Ken

[vlhperry]

Please consider taking the following LRRK-2 test offered by :

http://www.athenadiagnostics.com/site/product_search/test_description_template.asp?id=369

(copy above into your browser and click "Go." It is sometimes paid by your health provider if your doctor asks for it. Up to 50% of young onset patients have this mutation in their gene.

You could join a genetic research group. The problem with that is you sign away all rights to the knowledge of the outcome of the test. After being diagnosed with PD for 12 years, I went for a DBS evaluation and was told I had Post dystress syndrome and not allowed to talk to a surgeon. I was forced to prove I had PD by a LDopa PET Scan and the test mentioned above, which both were positive. I was allowed to have DBS surgery as a result of this test. It saved my life.

I had had two drug holidays (admitted to hospital and put into a coma while they flushed the toxins from my system as my dyskenesias were so severe they were causing my kidneys to shut down as they couldn't handle the amount of protein being broken down in my system.)

Since I have had DBS I was able to cut back Sinemet to 3 25/100 a day.

Sincerely,
Vicky

PS since the surgery can only take you to your best day on drugs, it is better to have it earlier than later.

[Capri]

Also Ken-
BEFORE you get a down pat diagnosis, make sure you have long term health insurance. Better to be safe than sorry. If it DOES turn out to be Parkinson's, the meds can get very costly!