Not that I don't get enough research time in with PD...ha, I am most curious about the apparent links between ET and PD. Largely, I am concerned because I was initially diagnosed with ET and for 6 years, my tremor looked and acted only like ET. It wasn't until 2007, it started to look and act suspiciously. When I was upgraded to PD, my neuro suggested that I may have both disorders as my tremor is still a little atypical for PD. I've also read here and in other forums many receive an initial ET diagnosis.

This leads me to wonder, how many of us young onset PD people are given an ET diagnosis instead of a 'possible PD' because our MDSs and Neuros just aren't sure? OR, is ET really just an early manifestation of a milder form of PD?

Here are some very interesting facts collected over the last several years and published at Dana Foundation's Brain Web: Shedding Light on a Tremor Disorder

Autopsy of ET people show presence of Lewy Bodies in the brain and in 80% degeneration in the cerebellum and impact on the neurotransmitter GABA.

Clinically a person with ET is 4-5 times more likely to develop PD.


Clinically, essential tremor is now considered a neuropsychiatric disease that can include unsteadiness, abnormal eye movements, problems with coordination and cognitive changes that sometimes progress to dementia.

Rick, does this sound familiar?

Even certain personality types tend to be overrepresented among patients with essential tremor, Dr. Louis said. Many “are very detail-oriented and tightly wound and have higher harm-avoidance scores,” he said.

Toxins in the brain including lead and harmane (a toxic byproduct from grilling meats) are leading environmental triggers.

My thoughts are that this is just one thing along the PD continuum; I am beginning to think that ET is really an early, early expression of what may evolve into a tremor dominant PD. What's interesting is what this means? If it's early on and stays just a tremor, what causes progression in some people, but not others? What do the differences and similarities translate to for PWP in researching etiologies and in developing treatment?

Anyway, wondering how many of you presented with an action or postural tremor only and told it was ET? What do you make of these findings?

Laura

Laura - the one major difference between ET and Tremor Dominant PD is that TDPD patients have a lower incidence of cognitive difficulties or eventual dementia than those who do not have a tremor.

It's a tangled mess!

I am still in limbo when it comes to a diagnosis and it is frustrating. I also wonder about the possibility of dealing with BOTH PD and ET. Some of my first symptoms were shaky legs when I was climbing stairs, muscle weakness, fatigue, stiffness, and jerky movements of my hands whenever I moved my forearms(cogwheel rigidity). I do experience a slight resting tremor at times. It is most pronounced if I become upset about something or if my hand is resting in a certain position. I was initially told that there was a 50-90% chance that I had PD and I was put on Requip, then Mirapex. Although I responded to the meds, I didn't respond as well as my doctor wanted me to. That led me to a MDS that diagnosed me with a Physiologic Tremor. His office closed. That led me to Neuro #3 who diagnosed me with ET. That diagnosis doesn't make sense to me because ET rarely affects the legs, and it doesn't cause stiffness and pain. The Metoprolol(ET Med) didn't work for me to reduce my tremors. Valium didn't work to reduce my tremors. That is supposed to reduce ET tremors. Alcohol doesn't work for me to reduce my tremors. Alcohol is supposed to reduce ET tremors. The only thing that has ever helped with my stiffness has been dopamine agonists and Sinemet. It is because of this that I have decided to return to my first Neurologist. The stiffness that I am experiencing in my neck, upper back, across the tops of my shoulders, and my right elbow is almost more than I can handle right now. I am taking Robaxin and it doesn't do much for me. I am looking forward to my appointment with Neuro #1 in February. I just want some relief from this stiffness and pain.

All I can say is whatever this turns out to be really sucks.

But I was diagnosed initally diagnosed as having ET because I was too young for PD (53). My tremor was not resting and did abate with alcohol, but it was only on one side. It did not lessen with klonapin no matter how many I took. A year later an MDS diagnosed PD. He said the fact that the tremor was atypical for PD was not unusual.

I used the fact that it was atypical to support my denial for years.