It can be difficult to ascertain the difference between essential tremor and Parkinson’s disease, both in the early stages of the disease and as it progresses. Different tremor types (rest, postural, kinetic, and intention) can be seen in both essential tremor and Parkinson’s. A patient can also have both diseases at the same time. It takes detailed clinical examination and neurological findings to differentiate patients with each condition.
Essential Tremor vs. Parkinson’s Disease: The Differences
|
Parkinson’s Disease |
Essential Tremor (ET) |
|
Seen mostly at rest |
Seen mostly during action |
|
High amplitude, lower slower frequency tremors |
Low amplitude, more variable, ranging from barely perceptible to high amplitude. Higher, faster frequency. |
|
Rarely a family history (less than 10%) |
Family history in majority (>50%) |
|
Involves slow movements (bradykinesia), rigidity, stiffness, and problems with walking or balance |
Postural, kinetic, postural tremor is easy to see, resting tremor uncommon |
|
Onset usually between 55-65 |
Onset common during middle age |
|
No effect from drinking alcohol |
Alcohol can improve tremor symptoms |
|
Starts on one side of the body and moves to the other side often stays asymmetrical |
Usually affects both sides of the body at the same time |
|
Often improves with levodopa |
Can improve with primidone and propranolol |
|
Affects hands more than legs, voice and head not affected usually |
Hands most commonly affected, but tremor also present in head and voice, rarely present in the legs |
|
Can get worse with emotional stress |
Can get worse with emotional stress |
 |
| Parkinson’s Disease vs. a healthy patient. Source: nih.gov |
Why Distinguish Between Parkinson’s and Essential Tremor?
Distinguishing between the two diseases is important in determining the correct course of treatment to pursue, as well as letting patients know how the disease will progress. Parkinson’s disease can be debilitating and tragic, while ET just needs to be treated correctly to be controlled. If you’re not sure if you have essential tremor or Parkinson’s disease, discuss your diagnosis with your doctor. When a patient meets all the diagnostic criteria for one of the two diseases, it’s relatively simple to separate Parkinson’s and essential tremor. But when signs of both diseases appear, it can be difficult to diagnose.
