07-25-2008, 07:22 PM
Hello. I am new to this forum and would appreciate any insight folks might have.
I am 39 years old. Exactly 8 months ago, during a period of extreme anxiety that required the use of a benzo prescription, I had a sudden onset of postural tremors in my hands, all my fingers and both wrists. I quickly discontinued the benzo.
Each of the tremors subsided after about one week, but I am left with a unilateral tremor in my right pinky finger, which I have now had consistently for the entire 8 month period. The tremor is only present when I hold my hand in a "cupped" position, when supinated. It is not present when I hold my hands stretched out in front of me, when I spread my fingers, or when I do a finger-to-finger test. Stress makes it worse.
I thought this might be a psychogenic tremor at first because it had a sudden onset during an anxious time with other tremors, but I have read that psychogenic tremors do not present in fingers. I have also read that Parkinson's tremors start unilaterally, but are rarely sudden onset, and very rarely begin as postural finger tremors. Finally, I have read that Essential Tremor is postural, but usually bi-lateral, not unilateral.
Not knowing how to classify this tremor has caused me great discomfort. My question is, given the positional, postural, unilateral, and sudden onset nature of this tremor for the past 8 months, does anyone have any ideas as to what the diagnosis/outlook is for such a pattern?
In the case of ET, we don't receive much hope from our doctors, and, there is good reason for that: Individual doctors know less about the disease than we, who have it, know about it collectively. It is my belief the disease is genetic. It is the genetic type that I refer to. There should be a different name (and perhaps there is) for tremor cause by exposure to some kind of chemical or trauma.
I am 75 years old and have had ET all my life. It has not gotten noticeably worse, nor has it gotten any better. Let me hasten to say that everything I say is my own opinion. Based on my opinion, let me tell you what I have experienced and carefully observed and have formed opinions based on these observations, what I have read and what I have been told by doctors.
My own experiences:
I believe I was born with ET, I believe if you consume a moderate amount of alcohol (I don't) it will not only help the ET, it will distinguish it from MS. Alcohol has no affect on MS, it does have a calming affect on ET. Social situations makes the condition worse. If you see some one watching you shake, you will shake worse. As you get older and more confident, your tremors will calm down slightly; however, the slow progression of the disease may offset that. When I am fatigued my tremors are much worse, in particular, if I have, for instance, been carrying a heavy brief case.
Anxiety and all those body defenses that come to your aid when you are negatively excited exacerbates ET significantly. If you have discovered a way to communicate with yourself and tell yourself to just relax and slow down you will see improvement. Tremor is worse in your dominant hand. I started drinking coffee using my left hand to hold the cup. That helped me for seven or eight years, now, both hands are about the same.
It is my belief that anything you can do to slow down your reflexes (alcohol or tranquilizers) will likely help.Otherwise, I don't think any medication will help and can make the condition worse. As a matter of fact, I as a layman, look at the medical ET specialty as a lot of "snake oil". I wish I did not feel that way but I do. Let me tell you why I feel that way:
I visited, as a patient, one of the top medical treatment centers and teaching hospitals in the world. While speaking to one of the top neurologists there, I noticed he had ET. I asked him if he had ET and he confirmed that he did. When I asked him what he did to treat it he told me that ET was not treatable. He went on to tell me there was a popular medication but was largely ineffective. It was at that moment, I had confirmed in the most honest and direct way there was indeed no treatment. It confirmed what I had always believed.
I would much prefer the medical industry devote their time to research and cure rather than treatment. I realize there are cases that are so severe, neurological intervention may be appropriate. If you are taking medication and it is helping you, albeit placebo in nature, by all means continue.
I have always lived with ET treating it as a nuisance and realizing it is what it is and I nor the medical profession can change that and I am not going to let it rule my life. Again, I must hasten to add, we are all different and are affected differently by different things. If you observe people that consume excessive alcohol they fall into three categories:
1) They become lovers.
2) They become belligerent.
3) They fall asleep.
If you are the type that falls asleep, I would suggest you are most likely to benefit from the alcohol. This by no means is a long term solution. I am not willing to trade my ET for alcoholism. It may help a little in the diagnosis of your condition.
When my father was born, life expectancy was approximately age 40. Only 50% of babies lived to adulthood. As doctors learn more about gene therapy and our politicians support embryo research, ET will be cured and, separately, our life expectancy will be well in excess of one hundred years.
I feel lucky that my ET is pretty much limited to my hands.
The above is the kind of opinion (as opposed to advice) I give to those who ask. I hasten to add that it is my own opinion and they have to make up their own mind if joining ET Groups or long term medical treatment really helps.
Do keep a diary and write in it any time your ET changes even slightly. For instance record the affect of decaffeinated coffee, a cocktail. an argument, fatigue, which hand is worse etc. Try to measure your tremor so that 5 years from now you can measure its progression/regression.
Try to accept the idea you likely will not find a cure or an effective treatment. In particular, be careful about accusing it of causing or exacerbating some other medical condition you have.
Since I originally wrote this, I would like to add one caveat relative to treatment:
I am reading more recently the benefit of deep brain stimulation. It seems that no one that has ET and have had deep brain stimulation reports anything but positive results, so, do your own research here. I do know that before I resorted to that, I would want to go back to the neurologist that has ET and ask him why he has not tried it. I do, however, suspect his (and mine) mild form of ET would make you think twice about it.
Just the words "Deep Brain Stimulation" scares the heck out of me. If my ET were worse than it is, I would look in to it and would only have it done at Mayo Clinic or someplace equally as prestigious.
07-29-2008, 06:00 PM
Thank you, Boyd. Your experiences are very helpful and informative. The thing I struggle with is the suddenness with which this happened, and the fact that now it only occurs in one finger during a specific position. Having said that, I am working on ways to reduce anxiety and stress. Social situations do make it worse, as you mentioned.
In your experience, is the tremor more or less always there, or are there periods of a significant withdrawal where the tremor is not present for a period of time?
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