HEALTH
It’s thought one million people in the UK have ‘essential tremor’, which causes shaky hands, and sometimes heads. Could a high-tech soundwave treatment provide help at last?
When Valerie Bryan’s hands started shaking so much she couldn’t eat without stabbing her lip with a fork, she knew it was finally time to see a doctor about her tremors.
‘I had to drink coffee and tea – and my gin and tonic – with a straw,’ says Valerie, 73, a retired music teacher from Ullapool, Scotland. ‘At home I couldn’t do any sewing as I couldn’t even thread a needle, and playing my flute was becoming increasingly difficult too.’
Valerie is one of around one million people in the UK who have a condition called essential tremor, the most common movement disorder. Essential tremor is generally an isolated, rhythmic tremor that affects both sides of the body, most commonly the upper limbs. It can also involve the head and voice and, less commonly, the legs. It can affect any age – around 5% of cases start in childhood – but is more noticeable in older people as it can get worse over time.
‘Essential tremor isn’t a symptom of a neurodegenerative disease but a subtle tremor that tends to start with movements such as writing or eating – or any activity where you are trying to do something,’ explains Jonathan Hyam, consultant neurosurgeon at the National Hospital for Neurology and Neurosurgery at Queen Square in London.
‘It’s known as a benign tremor, but in some cases it can be progressive and eventually have a major impact on quality of life, making it difficult to do basic activities such as cleaning your teeth and eating or drinking. As a result, people can become socially isolated as they are embarrassed to be seen shaking in public. However, it doesn’t always follow this course – it can be mild and will reach a plateau.’
Essential tremor is eight to ten times more common than Parkinson’s, a neurodegenerative condition that also causes tremor but comes with other symptoms. It’s why it is so important to get any tremor checked out by a doctor, says Mr Hyam.
The cause of essential tremor isn’t fully understood. Sufferers have abnormal activity in a brain circuit involved in movement, from the cerebellum at the back of the brain to the thalamus in the middle. It tends to run in families and is made worse by anxiety and nervousness.
For Valerie, tremor had been part of her life since her teens and was especially noticeable when she was nervous. ‘I could manage to play and sing, but my hands would shake holding the music and sometimes my head would shake as well,’ she recalls. ‘I just blamed myself for being anxious. I didn’t even think it was a medical condition and never saw a doctor about it.’
By her forties, Val
