by Gregory Todd, PA-S

Parkinson’s disease (PD) and Essential Tremor (ET) are neurological disorders that affect movement. Both disorders are associated with tremors in the arms but the timing and characteristics of the tremor can help distinguish between PD and ET. Each disorder can interfere with activities of daily living. Before diving into the symptoms seen in both disorders, let’s take a minute to understand each disease.

Parkinson’s disease is a chronic and progressive disorder of the nervous system that affects movement. Parkinson’s is caused by the destruction of neurons in a particular area of the brain called the substantia nigra. The death of these nerve cells decreases a nerve chemical (dopamine) which helps control movement and coordination. As the amount of dopamine decreases, an individual’s ability to control their movement is diminished.

Essential tremor is a disorder of the nervous system that causes involuntary and rhythmic shaking. The true cause of ET is still not fully understood but it is believed to be caused by abnormal electrical brain activity in the thalamus (a structure deep in the brain that coordinates and controls muscle activity). Genetics also play a role in ET which is why it is seen more commonly in families who have multiple members affected by the disease.

Distinguishing Features:

Parkinson’s Disease

  • Tremor in the hands in a resting position
  • Tremor that decreases with purposeful movement
  • Slowness of movement
  • Stiffness of arms, legs, and trunk
  • Impaired balance and coordination with shuffling gait
  • Symptoms progressively worsen over time

Essential Tremor

  • Tremor in the hands/arms primarily on use (i.e. eating, writing)
  • Tremor can increase during periods of stress
  • Tremor will lessen at rest
  • Can be associated with a shaking voice

It is important for any individual who starts to experience a tremor in their arms or legs to be evaluated by a neurologist. Medications for Parkinson’s disease and Essential Tremor can help reduce the symptoms and improve quality of life.

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