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Parkinson's Disease

Parkinson`s vs essential tremors

06/05/2007

Question:

My mother and I have `essential tremors` and it affects our hands when we try to do something like holding a cup, a spoon, writing, etc. Our handwriting is shakey. My sister also has essential tremors, but she has it much worse; her hand will shake just doing nothing. But the odd thing is, her handwriting is fine, no shakiness. If she has Parkinsons instead of essential tremors, would that explain why she has it worse than we do in her hands yet her writing is fine?

Answer:

From the description, your sister's tremor does sound to have a tremor with different characteristics than that of your mother and yourself.  Both Parkinsonian tremor and essential tremor have a wide variety of appearances.  In general, Parkinson's disease is not diagnosed by tremor alone.  It is diagnosed clinically based on the presence of 4 cardinal features:

1) Bradykinesia (slowness and decreased amplitude of movements)

2) Rigidity (increased muscle tone to passive range of movement)

3) Postural instability (easy loss of balance)

4) Tremor (typically a resting tremor)

Given the variability of tremor presentation, I recommend your sister be evaluated by a neurologist.  If it is a Parkinsonian tremor, this could explain the difference you have observed.

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Response by:

Punit Agrawal, DO Punit Agrawal, DO
Assistant Professor of Neurology
College of Medicine
The Ohio State University

Karen M Thomas, DO Karen M Thomas, DO
Formerly:
College of Medicine
The Ohio State University