DEAR DR. DONOHUE: My sister has been diagnosed with familial tremor. It has become so severe that she does not want to leave the house. She finds it difficult to write, drink and do many other things. She head shakes as well. She is very depressed. She heard about surgery and would like more information. – G.N.

ANSWER: Familial tremor – so named because it runs in families – is also known as essential tremor. It’s a shakiness of the hands that comes on at any age, but more often later in life. The tremor can make handwriting illegible, lifting a cup of coffee to the lips a hazard or trying to get a spoonful of soup into the mouth an impossibility.

The head can also bob, and the jaw can tremble. The voice might develop a quaver.

People often mistake this for Parkinson’s disease, but the Parkinson’s tremor comes on when the hands are resting quietly. This tremor comes on when the arms and hands are in action.

What medicines has your sister tried? Mysoline and Inderal are two popular ones. Topamax and Neurontin are two others.

Your sister will be greatly helped by staying away from caffeine or any stimulants. Wearing 1-pound wrist weights can sometimes stabilize hand movements.

The surgery that interests your sister is deep-brain stimulation. A neurosurgeon implants electrodes into the movement center of the brain and connects them to a generator placed under the collarbone, much like a heart pacemaker. The electric current generated can often abolish intractable familial tremor.

The International Essential Tremor Foundation has a Web site – www.essentialtremor.org – that has a list of regional specialists who can assist in finding doctors skilled in the procedure. If you don’t have access to a computer, your local library can help you. The foundation’s telephone number is 1-913-341-3880.

DEAR DR. DONOHUE: Two years ago I started getting little lumps on the palm of my left hand. I learned that one of my brothers had the same thing and had to undergo surgery to correct the problem. He told me it’s called Dupuytren’s contracture. Would you enlighten me about this?- D.B.

ANSWER: Dupuytren’s (dew-pwe-TRAHNS) starts as firm, small bumps on the palms. The bumps are bits of scarlike tissue that sprout tentacles that wrap around finger tendons. Eventually, those tentacles draw the finger down to the palm in a locked position. It can happen to any finger, but the little and ring fingers are the ones most often involved.

The illness can be a family affair, but only 10 percent have another relative with it.

When the finger begins to bend, injecting the nodule with cortisone can sometimes slow progression. When the finger bend approaches 30 degrees, hand function suffers, and surgery is the answer.

DEAR DR. DONOHUE: I have seen questions about brain and aortic aneurysms but never about spleen aneurysms. I have one. It is 1.8 cm in size. My doctor wants to wait as long as possible for surgery. Do these aneurysms grow very fast? – S.F.

ANSWER: Aneurysms are bulges on an artery wall. Any artery can have one. They represent a weak spot that can break and bleed.

Most spleen aneurysms – and about 2 percent of the population have one – produce no symptoms. A few cause vague stomach pain. Sudden, severe pain indicates that the aneurysm has burst, and action must be taken quickly to prevent massive bleeding.

Aneurysms greater than 2 cm in diameter are usually treated, and that can involve different approaches. The involved artery might be removable. Sometimes, tiny pellets can be deposited in the artery. The pellets form a clot that seals the aneurysm. And there are times when the entire spleen has to be removed.

Spleen aneurysms don’t usually grow rapidly.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.