About tremor

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What is Essential Tremor?

Essential tremor (ET) is a common neurological condition affecting up to 800,000 Australians. ET causes tremor of the hands and sometimes head and voice.

ET interferes with manual tasks such as writing, eating and drinking, causing considerable disability and social embarrassment.

The impact of ET on patients’ lives is often underestimated and beautifully captured in a quote from Lord Fellowes, renowned producer and ET sufferer:

Essential Tremor is a serious disability that has been largely ignored for too long. It may from the outside seem trivial or even comic that a person cannot hold up a cup or a glass or pour from a jug or write a postcard or tie their shoe laces or drink soup without the risk of leaving half of it down their front. But it is far from comic for the sufferer. It is distressing and degrading, a condition which makes hermits of its victims, that destroys skills and ruins social lives, and frequently results in chronic depression.

The idea that there is now a real and effective treatment that works – as opposed to pills that often don’t is immensely heartening. Once this is available to the general public, it will release many, many men and women from a humiliating prison where they have been held for far too long. I speak with knowledge, for I am a sufferer.

Lord Fellowes
Lord Fellowes
Renowned producer of Downton Abbey and ET sufferer

Treatments for tremor

Treatments for tremor range from no treatment for very mild cases, through to medications and certain neurosurgical procedures such as deep brain stimulation or mri guided focussed ultrasound thalamotomy

Medication

Medications such as beta-blockers, some anti-seizure medications and anti-anxiety drugs can be trialled. The side effects vary depending on the medication but can include fatigue or drowsiness. About 50% of people will get some reduction in tremor though the side effects can be limiting

Thalamotomy (open)

Thalamotomy is a neurosurgery procedure where a small hole is drilled into the skull and a tiny probe inserted into a part of the thalamus which is containing cells that cause or drive the tremor. These cells can then be destroyed leading to alleviation or complete resolution of the tremor. As with all neurosurgery procedures it carries some risks including bleeding and infection, and a small risk of paralysis, other neurological problems or more rare complications.

Deep brain stimulation

Deep brain stimulation involves drilling a small hole in the head and inserting a permanent electrode into the thalamus or other region causing tremor. This is then connected via a wire to a pacemaker box located in the chest region. It carries some of the same risks as open thalamotomy but also carries risks related to the hardware such as hardware infection. The pacemaker box can be rechargeable or fixed cell and generally will need replacement sometime between 3 and 15 years depending on which model is used.

MRgFUS thalamotomy procedure (Neuravive)

The Neuravive involves no incisions and the patient is fully conscious throughout. A stereotactic head frame is placed on the head with local anaesthetic and the patient lies in the MR scanner. If required some sedation can be given to help maximise comfort and relaxation during the MRI and procedure.

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