Shaky Hands Not Due To Nervousness

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DEAR DR. DONOHUE: Will you please provide information on essential tremor? Thanks. — D.C.

ANSWER: When people unfamiliar with essential tremor see a person with it, they immediately assume that the person is quite nervous. The shaky hands are a giveaway. It’s not “nerves” that are causing the shakiness; it’s essential tremor. A glitch in one of the brain’s movement-control centers has occurred. Katharine Hepburn suffered from essential tremor. Not only did her hands shake, but so did her head and her voice.

Essential tremor is a common condition. Its other name is familial tremor, indicating that it runs in families. Most affected people can find other relatives who have it.

Trembling hands make it near impossible to bring a spoonful of soup to the mouth. Handwriting often degenerates into a scrawl. Buttoning a shirt or coat becomes a herculean task.

Alcohol abolishes the tremor for a short time. Alcohol can’t be used as a treatment. Other medicines, like propranolol (Inderal) and primidone (Mysoline), offer effective control. For seriously disabling tremors, deep-brain stimulation can put an end to them.

People can help control shaking hands by holding their elbows firmly against the body when using their hands for a fine task.

Everyone with essential tremor needs to make the acquaintance of the International Essential Tremor Foundation at 888-387-3667 (toll-free) or online at www.essentialtremor.org. The foundation is a reliable source of information and can keep you up to date on new treatments.

DEAR DR. DONOHUE: Many years ago, we moved to a small community next to the ocean. We have eaten large quantities of fish ever since. I have developed a parasite called pinworms, which I believe came from partly uncooked fish. I used to see them when they exited from my colon (backside). They are fewer now that I take Oregano Leaf Oil. Can they cause other ailments or infiltrate other organs? How does one get rid of them once and for all? — J.D.

ANSWER: Pinworms are an extremely common infection, especially in children. During the night, the female pinworm crawls out of the rectum to lay eggs on the nearby skin. She is tiny, 0.4 inches (1 cm) long. You must have good eyes to see these worms. A magnifying glass is a big help. Pinworms rarely make their way to other organs. Some speculate that they might be a cause of appendicitis.

Eggs on the skin cause intense itching. Your doctor is best equipped to make the diagnosis. Doctors have the instruments to clearly see the worm or its eggs. Mebendazole (Vermox), albendazole (Albenza) and pyrantel pamoate (Pin-X) have a good track record of getting rid of pinworms. They are not found in fish.

Undercooked freshwater fish can harbor the fish tapeworm, which grows to a length of 39 feet. It produces few, if any, symptoms. Prolonged infection with it can lead to vitamin B-12 deficiency. For diagnosis, a stool specimen should be sent to a lab experienced in identifying the eggs and the worm segments. Praziquantel (Biltricide) is the treatment.

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