By Dr Chiba – Family Medical Practice

In the lively rhythm of Vietnamese life, subtle health changes can be missed. Yet, for many, involuntary shaking, known as essential tremor (ET), can deeply affect daily function and emotional health.

ET is the most common tremor disorder, marked by "action tremors", shaking during voluntary movement or when holding a posture. It usually begins gradually and worsens over time. Most often affecting the arms and hands, it can also involve the head, voice, or legs. Unlike Parkinson’s resting tremor, ET occurs during activity.

Daily challenges of ET
ET makes everyday tasks frustrating. Writing, eating, threading a needle, using a smartphone, or holding a bowl of phở can become difficult. Many patients feel embarrassed or socially withdrawn. Stress, common in busy cities, often worsens symptoms. 

What might contribute
Though the exact cause remains unknown, genetics plays a major role, up to 70% of cases have a family history, especially with early onset. Other possible contributors include:

• Lifestyle: Caffeine, alcohol, smoking, and some foods may worsen symptoms. Though small amounts of alcohol might temporarily help, it’s not a long-term solution.
• Environmental exposures: Pesticides, solvents, or heavy metals.
• Head trauma: Particularly in older adults.

Beyond the shaking
ET is more than a motor issue. It may involve:

• Cognitive issues: Problems with memory, focus, or verbal fluency. Late-onset ET may carry increased dementia risk.
• Mental health: Anxiety and depression are more common, along with fatigue and sleep problems.

ET vs. Parkinson’s disease
People often confuse ET with Parkinson’s. Key differences include:

Diagnosis and management
Diagnosis of essential tremor is clinical, based on history, exam, and family background..

Treatment aims to reduce disability and improve quality of life. Options include:

• Conservative care: Reduce stress, avoid triggers (e.g., caffeine), and use tools like weighted utensils or adaptive tech. Occupational and physical therapy are helpful.
• Medication: Propranolol and Primidone are common first-line drugs. Others like Topiramate, Gabapentin, or Atenolol may help. Short-term meds can assist during stressful events.
• Advanced options: For severe cases, Deep Brain Stimulation (DBS) or MR-guided Focused Ultrasound (MRgFUS) may be offered. Some wearable nerve stimulators provide temporary relief. These interventions require thorough evaluation at specialized centers.

While research continues, personalized care helps people with ET live fulfilling lives. Seek professional advice early to explore the best path forward. - Family Medical Practice

Dr Chiba Hiroshi is a Japanese family doctor with 20 years of experience working in Japan and Cambodia, specialising in primary care, travel medicine and urgent care. He graduated from Tohoku University School of Medicine in 1998 and received his PhD in Geriatrics in 2004. He provides consultation on a wide range of health problems for all age groups. Other areas of speciality and interest include infectious disease, infection control and medical education.

FMP Healthcare Group operates medical centres in major cities including HCM City, Hà Nội and Đà Nẵng, offering consultations with international doctors, check-up centres and emergency ambulance services.

Visit FMP Hanoi 24/7 at 298I Kim Mã Street, Ngọc Hà Ward, Hà Nội.

To book an appointment, please call (024) 3843 0784, or contact via WhatsApp, Viber or Zalo on +84 944 43 1919, or email hanoi@vietnammedicalpractice.com.