“Idiopathic tremor is the most common cause of tremor in the context of neurological disease. In essence, it is a syndrome characterized by a slowly worsening tremor (tremor) of the upper limbs. It is a disorder of the neural circuits that synchronize the movement, while the rest of the central nervous system (brain and spinal cord) is not affected”, points out the Mr. Fotis Bourlogiannis Deputy Director of Neurosurgery Metropolitan Hospital, which mentions the characteristics, diagnosis and treatment of the disease:

What are the most common features of essential tremor?

Idiopathic tremor is characterized by:

• Progressive and slow deterioration usually affecting both upper extremities, but asymmetrically. The head, voice and face are also affected.
• Tremor worsens in certain hand positions and during movement.
• The intensity of the tremor varies and is aggravated by stress, fatigue, hunger, extreme temperatures, etc.
• In 50-70% of patients the tremor temporarily improves after the use of alcohol but a “rebound effect” may occur, i.e. an immediate recurrence of the symptoms.
• A thorough neurological examination is needed to confirm the diagnosis, since idiopathic tremor has common features but also important differences from normal conditions such as senile tremor or neurodegenerative diseases such as Parkinson’s.

How is essential tremor diagnosed?

The diagnosis is made by a clinical examination as well as an examination of the family history. Imaging is required to rule out other causes.

Given the multitude of conditions that can cause secondary tremor as well as neurological conditions that present with tremor and other symptoms, a neurological examination by a specialist in movement disorders is essential.

Can it be hereditary?

“There is a hereditary history in at least 50% of patients. Inheritance is autosomal dominant, with limited penetrance. In some cases, gene variants within the family have been found. The rest are sporadic cases of unknown etiology” emphasizes Mr. Bourlogiannis.

Treatment

Pharmaceutical treatment, surgical intervention but also non-interventional methods help to treat the disease.

“Regarding the available treatment options, primidone and propranolol offer effective drug treatment in more than 50% of cases.

Deep Brain Stimulation is the interventional method of choice when symptoms persist despite chronic medication.

Briefly, DBS consists of the stereotactic implantation of electrodes through which the abnormal neuronal circuits of the brain are modified. It is a safe and effective surgical method, reversible, modifiable and resistant to time.

There are also non-invasive therapeutic methods based on stereotaxy but to induce irreversible transection. A new technology that is gradually becoming established is focused ultrasound with stereotactic magnet guidance.

Radiofrequency stereotactic cross-section induction is a traditional method that, with the appropriate indications, is used with great efficiency. Stereotactic radiosurgery (γ-knife) is also indicated in specific cases”, explains the specialist.

The epidemiological data of the disease

The number of people who are sick in the total population is estimated to be 0.32%. On a global scale, incidents for 2020 amount to 24.91 million. Women and men are affected with equal frequency. It usually appears at the age of 35-45.

Mortality is no different from the general population, because essential tremor is not a neurodegenerative disease that affects expectancy. However, the resulting disability is significant in 85% and severe in 15% of patients”, concludes Mr. Bourlogiannis.

*The standard and well-equipped Neurosurgery Clinic of the Metropolitan Hospital

Metropolitan Hospital has a standard and well-equipped Neurosurgery Clinic, staffed with experienced medical and nursing staff, available to patients to address any problem or ailment.

The Clinic’s equipment includes state-of-the-art machines, instruments and systems, which contribute decisively to the effective treatment of diseases and injuries of the nervous system.

In the Clinic, operations are carried out that cover the entire spectrum of the neurosurgical specialty. Surgical operations are carried out concerning diseases of the brain, the intracranial vascular tree, pituitary diseases, as well as skull base diseases.

In addition, operations related to diseases of the spinal canal are performed, as well as special surgical operations, such as trigeminal nerve microvascular decompression.

Metropolitan Hospital, a member of HHG and one of the leading medical technology and robotics treatment centers in the country, remains true to its commitment to providing the highest possible level of healthcare services for each condition and each individual case.