Dr. Donohue

DEAR DR. DONOHUE: I have benign essential tremor. Friends and family are convinced I have Parkinson's disease because of the tremor in my hands, head and voice. Will you please explain the difference? -- L.R.

DEAR L.R.: When people see shaking hands, they immediately believe that the person is either nervous or has Parkinson's disease. Neither is true. Most of the time, the person has your condition, benign essential tremor, which affects 10 million Americans and is much more common than Parkinson's disease.

The tremor of Parkinson's disease is a resting tremor. It occurs when the hands are lying in the lap. The index finger constantly rolls over the thumb. The tremor of benign essential tremor occurs when a person uses the hands, such as bringing a cup to the lips or fitting a key into a lock.

Essential tremor is also called familial tremor because it so often runs in families. None of the other Parkinson's signs are seen with essential tremor. They include such things as an expressionless face, small handwriting, slow movement, rigid muscles and walking slightly bent at the waist.

Alcohol almost always abolishes essential tremor for a short time; it does nothing for Parkinson's tremor. Alcohol isn't a treatment, but other medicines often provide good suppression of essential tremor. Propranolol (Inderal) and primidone (Mysoline) are two examples.

DEAR DR. DONOHUE: Please stop telling people that nothing can be done for their tremors. I had an operation for my essential tremor. As you can see, I can write with ease. My tremor was bad beyond anyone's imagination. I have been very satisfied with the results of the operation. -- E.R.

DEAR E.R.: Are you sure I am the one your gun's barrel should be pointed at? I always list the many treatments for essential and other tremors. I never have said they are untreatable.

For those whose tremor doesn't respond to medicines or whose tremor is incapacitating, deep-brain stimulation often can stop it in its tracks.

The stimulator is a pacemaker-size device put under the skin of the chest. Wires from it are threaded to the part of the brain responsible for the tremor. Stimulation of that brain area stops the shaking for most. I am happy to hear you had such gratifying results.

DEAR DR. DONOHUE: I have enclosed a list of my husband's medicines. I have no idea what his health problem is, and I get little information from him. He has no energy, walks slowly and loses the drift of conversation. I appreciate your help. -- B.S.

DEAR B.S.: A much better idea than having me give you a brief description of his medicines is to accompany your husband during his doctor visits and stay with him when the doctor examines him. The doctor will appreciate your input.