December 8th-10th, you can join Case Integrative Health's Dr. Rana Mafee, MD, ABoIM for the Essential Tremor Speaker Series. Dr. Mafee will be speaking alongside world-renowned doctors, scientists and researchers on Essential Tremor- a nervous system disorder that causes consistent shaking.
To find out more about this disorder that impacts more than 200,000 people in the U.S. alone, the Case Integrative Health communications team sat down with Dr. Mafee to learn the basics:
Q: First of all, I would love to hear a little bit of background information on the condition Essential Tremors, as I, personally, don’t know a lot about it. How would you describe the condition, and how common is it?
A: Essential tremor is a benign condition that causes a tremor characterized by involuntary movement that is oscillatory, meaning it moves around a central plane. It is categorized as a “kinetic” tremor, because the tremor is notable during action and movement, in contrast to a resting tremor such as observed in Parkinson’s Disease. It presents in the upper limbs, but with time can involve with neck, voice and jaw. One might notice the tremor with actions such as with eating and writing if limited to the upper limbs.
Q: Do we know anything about what causes Essential Tremors? More specifically, Is it genetic, or are there other risk factors?
A: We do not know that exact cause of essential tremor, but we do know that about 50% of cases are genetic. We know that certain cells in a part of the brain called the cerebellum become dysfunctional. These cells exhibit dysfunction of the neurotransmitter GABA. While not entirely clear it is proposed that there may be some component of neurodegeneration involved.
Q: What do the current treatment options look like, and what do you, as an expert, recommend to your patients?
A: First line treatments are pharmaceutical medications. Typically either Propranolol or Primidone. It is estimated that at least 50% of people will have mild to moderate reduction in their tremor. If neither of these are effective, then we move on the second or third line medications. And if medications are not effective for an advanced case, there are some surgical options as well, such as deep brain stimulation or thalamotomy.
Q: How could I support a family or friend who is diagnosed with Essential Tremors, and is there anything I
can do to help with their treatment?
A: Essential tremor is a benign condition, meaning that it will not pose any life threatening harm to a person. However, there can be significant morbidity, meaning that it can limit one’s interests and abilities. This is particularly the case for those who use their hands a lot, such as musicians, surgeons, and mechanics to name a few. And if there is involvement of the neck, jaw or voice, one might have different limitations as well. Patients with essential tremor should take comfort in knowing that medicines can be moderately effective for this condition. However, using a functional medicine approach can significantly enhance the treatment. Focusing on the gut and gut-brain axis and delving into any underlying triggers and mediators can be of great benefit. Since neurodegeneration may be involved, specifically looking into any potential toxins or infections may be beneficial.
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*The Case Integrative Health blog does not give medical advice. If you are interested in making an appointment at Case Integrative Health, please contact the office at (773)-675-1400.
Additional contributions to this article by Anna Roberts.