Dr. Gurneet Singh Sawhney is an expert neurosurgeon who has successfully treated patients suffering from varied neurological disorders including essential tremor disorder too.

He is an accomplished neurosurgeon with expertise in Vascular Neurosurgery, neuro intervention, functional neurosurgery, neurotrauma and stereotactic, seizures, and so on. He is considered one of the most skilled and accomplished neurosurgeon in Mumbai.

What is an Essential tremor?

Essential tremor is a movement disorder that gradually progresses either affecting the posture or as a kinetic tremor. Generally, it is known to affect the upper extremities. Also, it has yet to be confirmed whether the disorder can be classified as a neurodegenerative disorder.

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Symptoms of Essential Tremor

Patients with essential tremor display a tremor in one upper extremity followed by its spread in the other upper extremity but it rarely does spread to the lower extremities. However, they could develop gait and balance abnormalities. They can also affect the voice, jaw, lips, head, and face.

 

The primary symptoms related to essential tremor include

Symptoms of Essential Tremor

  • Uncontrollable trembling that happens for brief periods of time
  • Shaking voice
  • Nodding head
  • Tremors that deteriorate during phases of emotional stress
  • Tremors that get intense with determined movement
  • Tremors that reduce with rest
  • Balancing difficulties (in some cases)

Tremors could be occasional i.e. occurring during highly emotional moods and are likely to become persistent. They can be slightly asymmetrical while their frequency remains fixed. It is observed that tremors can occur during highly volatile emotional situations, temperature variations, and also due to fatigue, hunger etc.

A patient with essential tremor may be able to control it through voluntary control or suppress it by doing certain skilled manual tasks. Also, Sleep and relaxation are the best ways to resolve a tremor condition

Causes of Essential Tremor

irregular electrical brain activity

The real cause of Essential Tremor is still unstated, but it is believed that the irregular electrical brain activity that causes essential tremor is processed via the thalamus.  Another view states miscommunication between the cerebellum and other parts of the brain hence issues in muscle coordination.

Essential tremor can be passed down from the parent to the child to the extent of 50%. Hence, it is advisable to conduct genetic testing or brain imaging to ascertain the likelihood of essential tremor for better diagnosis.

Treatment for Essential Tremor

Essential tremor is usually managed through medication and surgery in severely affected patients. Primidone and propranolol are most relied upon medicines for managing these tremors. They are effective in reducing the amplitude of terror in more than 50% of the patients.

Primidone is effective in controlling the actions of the neurotransmitters while propranolol works encouraging neurotransmitters to reduce the tremors and their intensity. Their dosage has to be given with care keeping in mind the medical condition of the patient. Also, they can be given in combination for better outcomes.

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Surgery

Select neurosurgeries such as Stereotactic thalamotomy and thalamic ventralisintermedius nucleus deep brain stimulation are suggested to resolve patients from intensely severe essential tremor conditions.

These patients display disabling tremors that affect their quality of life and hence these surgery options are placed before them. Both these surgeries offer a significant reduction in tremors experienced in the contralateral arm and also in the tremors of the head and voice.

deep brain stimulation

Both these surgeries have their pros and cons, which should be thoroughly evaluated before proceeding with any of them. The cost of stereotactic thalamotomy is relatively much lesser than deep brain stimulation but it comes with its share of side effects while deep brain stimulation is effective in controlling the stimulation required to manage the tremors but on the con side, it is expensive and involves the implantation of a foreign body within the body which further requires maintenance after a couple of years.

There is no permanent cure for essential tremor, but treatments that offer relief from its symptoms might be supportive in enhancing the quality of life. Mild essential tremor might not need treatment.

However, if ET inhibits your capacity to function or if you find it socially unacceptable, there are treatments that may improve essential tremor symptoms. Treatments might include medications or surgery. For surgical assistance in treating essential tremors consult Dr. Gurneet Sawhney, an experienced and skilled neurosurgeon in Mumbai.

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Why choose Dr. Gurneet Singh Sawhney?

Dr Gurneet Singh Sawhney is an accomplished neurosurgeon practicing in Mumbai. Apart from academic excellence, he has gained competency in performing neurosurgeries and other interventional treatments that help patients recover from the brain and other nervous system disorders.

Additionally, he has acquired fellowships in Functional Neurosurgery and a Fellowship in Epilepsy Neurosurgery from Japan. He has acquired expertise in performing simple and complex spine surgery, including CVJ and minimally invasive spine surgery – MISS, deep-rooted tumors in the skull, CVJ surgeries, neuro intervention, functional neurosurgery, neurotrauma, stereotactic, seizures and much more.

Frequently Asked Questions

Essential tremor is a disorder that leads to tremors of the hands, and/or the voice and the head upon their movement while in Parkinson’s disease, tremors occur when the limbs are relaxed and at rest. In fact, tremors in Parkinson’s disease patients are less intense when they use their limbs.

Essential tremor can occur to anyone at any age but its onset has been observed in middle aged individuals across both sexes irrespective of race and ethnicity. Also, it can be passed down from parents to the children hence genetic testing is essential if there is an incidence of it in the family. Children with parents with essential tremor do or do not display symptoms associated with essential tremor.

Yes, the severity does progress over time, patients may experience increase in the severity of the tremor while the frequency can reduce over time. The tremors are likely to hamper motor skills especially eating, writing, grooming oneself. However, these tremors are well managed with proper medication taken under the supervision of an expert neurosurgeon.

It is important to choose a good neurosurgeon who suggests the right dosage of the most suitable medicine. There are many medicines that are equally effective in treating essential tremors but they should be prescribed keeping in mind the medical condition of the patient along with the likely side effects. Most prescribed medicines include Primidone, Propranolol, Gabapentin, Topiramate, and so on.

Deep brain stimulation (DBS) and thalamotomy are most preferred surgeries performed to treat essential tremor conditions. Both these surgeries are suggested only if the medication does not resolve the tremor conditions in the patient. Also, their pros and cons need to be evaluated in terms of cost, maintenance, side effects and other relevant factors.

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