2What is essential tremor? Everyone has some sort of tremor, but it is so small in most people that it is not noticeable. The most common type of tremor is essential tremor (ET). ET is eight times more common than Parkinson’s disease.Essential tremor can occur in different muscle groups, such as those of the arms, eyelids, or head, but it most commonly occurs in the hands. It is rare that the tremor is in the legs and feet. However, some people with ET have problems with gait.In essential tremor, the affected body parts shake at a rate of more than five times per second.Tremors occur during movement and are less noticeable with rest (action tremor).
3What is essential tremor? If the tremor is in the hands, the person has difficulty using tools, drinking from a glass or cup, writing, and drawing.The voice may shake or quiver if the tremor affects the larynx.The person affected may nod the head.The tremor does not occur during sleep.ET usually occurs on its own, not in combination with other neurological disorders.
4Who is affected?ET affects 4% of people 40 years of age and older, and much higher percentages of people in their 60s to 90s. It occurs most often in people over age 65.
5Causes of ETThe cause of essential tremor is not known, but it is evident that the nerves that enervate certain muscles and/or the parts of the brain that govern the movement of these muscles are not working properly.About one-half of cases of essential tremor run in families, so there is a genetic component (autosomal dominant transmission; i.e., from one parent).Environmental factors, especially toxins, are under investigation as potential causes of ET.Heavy metal poisoning, especially lead or mercury, can cause ET. Dental amalgam fillings contain 50% mercury.Chronic exposure to lead can cause ET. Sources of lead include old paint, plumbing products containing lead.
6Other Causes of ETConsumption of meat cooked at high temperatures in men: elevated blood harmane (1-methyl-9H-pyrido[3,4-b]indole), a potent neurotoxin, concentrations (also present in coffee and cigarettes)In one study, harmane concentrations were 50% higher in patients with ET than in controls.Due to an inability to process harmaneOther causes of tremor include medication side effects, thyroid disease, exposure to organic solvents and pesticides.
8More on AmalgamsAmount of mercury released from dental amalgam depends on thenumber of fillingssurface areachewing and eating habitsother chemical conditions in the mouth (galvanic action, evaporation, heat, acidity)Amount of mercury released from dental amalgams ranges from to 17 µg/day (Health Canada tolerable limit = 0.47 µg/kg/day).The mercury from dental amalgam may contribute from 0% to more than 75% of your total daily mercury exposure, depending on the number of amalgam fillings you have, the amount of fish consumed, the levels of mercury (mostly as methylmercury) in those fish, and exposure from other less common sources.Exposure to very small amounts of mercury does not necessarily pose a health risk.
9Amalgams ContinuedAutopsy studies reveal that the number of amalgam fillings corresponds with the amount of mercury deposited in the brain and other tissues.Higher mercury deposits in the brain are found with greater numbers of amalgam dental fillings.Animal and human studies show that mercury toxicity causes tremor.Tremors might result from the tendency of metallic mercury to accumulate in the cerebellum and basal ganglia of the brain.Four amalgam fillings should cause no observable adverse health effects in adults during a lifetime of exposure.Canadian adults with an average number of fillings (7) might exceed this limit.
10Signs and Symptoms of Mercury Poisoning personality changes (irritability, shyness, nervousness)tremorschanges in vision (narrowing of the visual field)deafnessmuscle incoordinationloss of sensationdifficulties with memory
12Signs of Lead Poisoning abdominal pain and cramping (usually the first sign of a high, toxic dose of lead poison)aggressive behaviouranemiaconstipationdifficulty sleepingheadachesirritabilityloss of previous developmental skills (in young children)low appetite and energyreduced sensations
13What makes ET worse? stress certain medications (antidepressants, lithium salts)caffeinelow blood sugarheat, coldintense emotionsfatigueperformance situations (e.g., presentations)
14What makes ET better?alcohol (induces relaxation)restful sleep
15Conventional Treatment beta blockersanti-seizure drugsmild tranquilizersbotox injections into the hands weaken affected musclesFor more severe cases where quality of life is severely affected:stereotactic radiosurgery (beaming X-rays to the affected part of the brain)stimulating devices implanted directly into the parts of the brain that control movement
20AcupunctureScalp acupuncture produces good results. Patients usually have an immediate positive response.Significant or complete reduction in tremor occurs in about 80% of people who receive scalp acupuncture.The norm is that tremors gradually decrease with each session.For some patients, the symptoms become worse during treatment.
21Why it WorksTherapeutic areas in scalp acupuncture are related to the distribution of acupuncture channels and network vessels in the head.These channels and network vessels communicate closely with the entire body.Areas stimulated in scalp acupuncture are projections of areas of the brain onto scalp locations.Each area corresponds approximately to a specific neurophysiological function in the brain.
25Why it WorksFunctions of the brain can be accessed at specific areas on the scalp.Many areas on the scalp interconnect with the brain through channels and network vessels, so they can be used to treat psychiatric and neurological disorders.The damaged brain can reorganize itself so that when one part fails, other parts compensate. Scalp acupuncture may stimulate the brain to create new nerve pathways in an area of brain damage.Nerve circuits in the CNS may be able to reshape themselves in response to external stimuli.
26AcupunctureIf tremors are not well controlled by scalp acupuncture alone, patients may experience better results when combining it with body and/or ear acupuncture points.
27Research1. Zhongguo Zhen Jiu. (Chinese Acupuncture and Moxibustion, 2010 Feb;30(2):107-9.[Clinical observation on acupuncture combined with medication for treatment of essential tremor].[Article in Chinese]Sui KM(1), Li X.Author information:(1)Department of TCM, Qingdao Municipal Hospital, Qingdao , China.OBJECTIVE: To observe the clinical therapeutic effect of acupuncture combined with western medicine for treatment of essential tremor.METHODS: Sixty cases of essential tremor were randomly divided into two groups, 30 cases in each group. The combined acupuncture and medication group was treated with acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Taixi (KI 3), etc. and oral administration of Propranolol; the medication group was treated with oral administration of Propranolol only. The comprehensive effects and the scores of tremor were observed after 30 days of treatment in the two groups.RESULTS: The total effective rate of 90.0% (27/30) in the combined acupuncture and medication group was obviously higher than that of 56.7% (17/30) I the medication group (P < 0.01), the tremor score of the combined acupuncture and medication group was obviously better than that of the medication group (P < 0.05).CONCLUSION: Acupuncture combined with oral administration of Propranolol has better therapeutic effect on essential tremor than that of oral administration of Propranolol only.
28How well does it work?80% of patients have a good response or major improvement early on.Having a positive response after the first treatment depends on-the nature and duration of the illness-the patient’s constitution-the patient’s motivation to improve
29How well does it work?In general, patients fall into 3 categories of improvement:-gradual and progressive-improvement of symptoms followed by return to presenting conditions (more likely in degenerative diseases such as MS and Parkinson’s)-exacerbation of symptoms followed by major improvementIn rare cases, there is no change.
30How many treatments do I need? It may take two or more treatments to notice a difference.It is common for patients to experience early positive results and then to reach a plateau of improvement after only a few treatments.After major improvement, treatments can be continued as infrequently as possible for maintenance.Treatment is initially given twice a week.A therapeutic course consists of 10 treatments.
31Summary Naturopathic treatments for ET: Eliminate toxins. Don’t cook meat at high temperatures.Avoid caffeine, alcohol, fatigue, stress, low blood sugar.Get adequate sleep.Eat a healthy diet.Take herbs and supplements.Acupuncture
32Should I have my amalgam fillings removed? Do I have more than 8?Are they corroded or decayed?No:Avoid acidic foods (tomatoes, grapefruit, vinegar, coffee)Garlic, cilantro
33Contact www.linamockusnd.com firstname.lastname@example.org Health in Davisville (Wednesday and Friday 10-6) Yonge St. Toronto, ON M4S 3B Ushta Integrative Health Clinic (Thursday 10-7) 3300 Yonge St., Ste. 300 Toronto, ON M4N 2L