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Parkinson’s Disease and Essential Tremor

Parkinson’s disease is a progressive disorder caused by degeneration of nerve cells in the part of the brain that controls movement. These nerve cells die or become impaired, losing the ability to produce an important chemical called dopamine.

According to the American Association of Neurological Surgeons, approximately 60,000 new cases of Parkinson’s disease are diagnosed each year, adding to the estimated one to 1.5 million Americans who currently have the disease. While the condition usually develops after the age of 55, the disease may affect people in their 30s and 40s.

Common Symptoms

  • Tremor, or the involuntary and rhythmic movements of the hands, arms, legs and jaw.
  • Muscle rigidity, or stiffness of the limbs – most common in the arms, shoulders or neck.
  • Gradual loss of spontaneous movement, which often leads to decreased mental skill or reaction time, voice changes, decreased facial expression, etc.
  • Gradual loss of automatic movement, which may lead to decreased blinking, decreased frequency of swallowing, and drooling.
  • A stooped, flexed posture with bending at the elbows, knees and hips.
  • Unsteady walk or balance.
  • Depression or dementia.

The diagnosis of Parkinson's is primarily based on the patient’s medical history. There is no X-ray or blood test to confirm the disease. However, noninvasive diagnostic imaging, such as a positron emission tomography (PET) scan can support a doctor's diagnosis.

The majority of Parkinson's patients are treated with medications to relieve disease symptoms. Levodopa is the most frequently prescribed medication for Parkinson’s, but there are several other medicines used to treat the disease.

Essential Tremor

Essential tremor is uncontrolled shaking or trembling, usually of one or both hands or arms, that worsens when basic movements are attempted. Essential tremor affects about five million people in the U.S. According to the U.S. National Library of Medicine, essential tremor is found most commonly in adults over the age of 65.

It is caused by abnormalities in areas of the brain that control movement and is not tied to an underlying disease (e.g., Parkinson's disease). About 50 percent of patients have a family history of the condition. Essential tremor usually does not result in serious complications, but it can interfere with daily activities and cause distress.

In some cases, physical therapy or changes in lifestyle may improve symptoms. If the condition affects a patient's ability to perform daily tasks and has a negative impact on quality of life, medication or surgery may be considered.

Deep Brain Stimulation (DBS)

For many patients with Parkinson’s and essential tremor, medications are effective for maintaining a good quality of life. As these disorders progress, however, some patients may have more difficulty controlling their movements.

While there are several types of surgeries to improve movement for Parkinson’s and essential tremor patients, deep brain stimulation (DBS) offers a good alternative to more invasive procedures.

During DBS, a hair-thin wire is implanted in the brain and connected to a neurostimulator implanted under the collarbone. The neurostimulator sends electrical impulses along the wire to the brain, interrupting signals that cause tremor.

After the procedure, the doctor adjusts the settings to optimize the therapy for the specific patient. Getting the initial settings adjusted correctly for the patient may take several sessions. Over time, the settings can be adjusted as symptoms change. A few weeks after the procedure, the patient can return to normal daily activities.

Deep brain stimulation is a procedure available at Providence Medical Center. To find a neurosurgeon, visit and click on find a physician.