DEAR DR. DONOHUE: I have benign essential tremor. Friends and family are convinced I have Parkinson’s disease because of the tremor in my hands, head and voice. Will you please explain the difference? — L.R.

ANSWER: When people see shaking hands, they immediately believe that the person is either nervous or has Parkinson’s disease. Neither is true. Most of the time, the person has your condition, benign essential tremor, which affects 10 million Americans and is much more common than Parkinson’s disease.

The tremor of Parkinson’s disease is a resting tremor. It occurs when the hands are lying in the lap. The index finger constantly rolls over the thumb. The tremor of benign essential tremor occurs when a person uses the hands — lifting a spoonful of soup to the mouth, bringing a cup to the lips, fitting a key into a door lock. Benign essential tremor also can affect the head. The head bobs in a yes-yes or no-no movement. That never happens in Parkinson’s disease. And the voice can take on a trembling quality — another sign that doesn’t occur with Parkinson’s.

Essential tremor is also called familial tremor because it so often runs in families.

None of the other Parkinson’s signs are seen with essential tremor. They include such things as an expressionless face, small handwriting, slow movement, rigid muscles and walking slightly bent at the waist.

Alcohol almost always abolishes essential tremor for a short time; it does nothing for Parkinson’s tremor. Alcohol isn’t a treatment, but other medicines often provide good suppression of essential tremor. Propranolol (Inderal) and primidone (Mysoline) are two examples.

People with essential tremor should introduce themselves to the International Essential Tremor Foundation. The foundation provides a wealth of information and can direct people to local support groups. The toll-free number is: 888-387-3667, and the Web site is www.essentialtremor.org.

DEAR DR. DONOHUE: Please stop telling people that nothing can be done for their tremors. I had an operation for my essential tremor. As you can see, I can write with ease. My tremor was bad beyond anyone’s imagination. I have been very satisfied with the results of the operation. — E.R.

ANSWER: Are you sure I am the one your gun’s barrel should be pointed at? I always list the many treatments for essential and other tremors. I never have said they are untreatable.

For those whose tremor doesn’t respond to medicines or whose tremor is incapacitating, deep-brain stimulation often can stop it in its tracks. The stimulator is a pacemaker-size device put under the skin of the chest. Wires from it are threaded to the part of the brain responsible for the tremor. Stimulation of that brain area stops the shaking for most. I am happy to hear you had such gratifying results.

DEAR DR. DONOHUE: I have enclosed a list of my husband’s medicines. I have no idea what his health problem is, and I get little information from him. He has no energy, walks slowly and loses the drift of conversation. I appreciate your help. — B.S.

ANSWER: Medicines have more than one use. My answer gives their common uses.

Allopurinol is for gout prevention; furosemide is a diuretic, a water pill; omeprazole stops stomach-acid production and treats heartburn; metoprolol slows the heart and lowers blood pressure; Cymbalta is an antidepressant, and it’s also used to control the aches and pains of fibromyalgia; neomycin is an antibiotic used to alter and suppress colon bacteria usually in preparation for surgery or to decrease their production of ammonia, a substance that dulls thinking.

A much better idea than having me give you a brief description of his medicines is to accompany your husband during his doctor visits and stay with him when the doctor examines him. The doctor will appreciate your input.

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.


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