Essential Tremor in India: Shaking Up Our Understanding
Dr. Sagar Betai
Do your hands ever shake when you're trying to do something precise, like thread a needle or sign your name? For most of us, a little trembling here and there is no big deal. But for the millions of Indians living with essential tremor, those shakes can make even simple tasks feel impossible.
What is Essential
Tremor?
Essential tremor (ET) is a neurological disorder that causes rhythmic
shaking, usually in the hands, arms, head, voice, or legs. It's often confused
with Parkinson's disease, but they're actually quite different. While
Parkinson's tremors usually happen when the body is at rest, essential tremors
fire up when you try to do something, like lift a glass of water or tie
your shoelaces.
ET isn't life-threatening on its
own, but it can seriously impact quality of life. Imagine trying to eat soup
with a shaky spoon, or sign a check with wobbly hands. For some, the tremors
are so severe that they can barely write, use a phone, or get dressed without
help.
Who Gets Essential
Tremor?
Here's the thing - essential
tremor is pretty common. Worldwide, it's the most prevalent movement
disorder, affecting millions of people of all ages. While exact numbers for
India are hard to pin down, some estimates suggest that ET may impact up to 10
million Indians to some degree.
And get this: about half of
all cases are thought to be inherited. If one of your parents has a gene
mutation linked to ET, you've got a 50-50 shot of inheriting it yourself. So if
shaky hands run in your family, it's worth paying attention to.
Living with Essential
Tremor in India
For many Indians with ET, daily
life can be a challenge. The constant shaking can make it tough to work,
socialize, or even take care of basic needs. Some people feel embarrassed or
self-conscious about their tremors, leading them to withdraw from friends and
family.
There's also the financial burden
to consider. While India is a world leader in medical tourism, offering
high-quality, affordable healthcare to international patients, the reality for
many Indians is quite different.
According to World Bank data, the
top 10% of Indians hold a whopping 57% of the country's wealth.
Meanwhile, the per capita income hovers around just 2.4 lakh rupees
(about $2,700) per year. So for the average Indian, paying for ET treatment on
top of regular expenses can feel next to impossible.
The Cost of Treatment
Speaking of treatment, let's talk
options. There's no cure for essential tremor (yet), but there are ways to
manage symptoms and improve quality of life. The main treatments available in
India include:
- Medications: Drugs like propranolol, primidone, and gabapentin can help reduce
tremors for some people. But they can also cause side effects like
fatigue, dizziness, and cognitive issues.
- Botox injections: Botulinum toxin shots can temporarily weaken
overactive muscles and ease tremors. But they're expensive, need to be
repeated every few months, and can sometimes cause muscle weakness and
pain. Plus, there's a risk of the body developing resistance over time.
- Deep brain stimulation (DBS) surgery: This involves implanting electrodes in the
brain to interrupt faulty nerve signals. It can be very effective for
severe tremors, but it's a major procedure with risks like infection and
stroke. The device alone can cost upwards of 22-23 lakh rupees -
almost ten times the average annual income in India.
- MRI-guided focused ultrasound: This newer treatment uses sound waves to target
overactive brain cells without cutting into the skull. It's less invasive
than DBS, but still costly. A single session can run around 30 lakh
rupees, putting it out of reach for most Indians.
The bottom line? For many in
India, getting proper treatment for essential tremor is a luxury they simply
can't afford. The result is countless people suffering in silence, unable to
access the care they need to live full, productive lives.
Finding Hope
But it's not all doom and gloom.
In recent years, Indian doctors and researchers have been working hard to
improve access to ET care and develop more affordable treatment options. While
there's still a long way to go, their efforts are starting to bear fruit.
One area of promise is non-invasive
brain stimulation techniques like transcranial magnetic stimulation (TMS)
and transcranial direct current stimulation (tDCS). These use magnetic fields
or mild electrical currents to temporarily alter brain activity and reduce
tremors. While not a permanent fix, they're generally safer and cheaper than
surgery.
Researchers are also exploring
novel drug targets and delivery methods to make medications more effective with
fewer side effects. Some are even looking into natural compounds like
caffeine and nicotine, which have shown potential for reducing tremors in early
studies.
The Road Ahead
As India continues to grapple
with the challenges of essential tremor, it's clear that we need a multifaceted
approach. That means:
- Spreading awareness and education about
ET, so people can recognize symptoms and seek help early on
- Investing in research and development to
find better, more affordable treatments
- Strengthening healthcare infrastructure so
quality care is available to all, not just the elite
- Providing financial support and resources
to help patients access existing treatments
- Tackling the root causes of health disparities,
like poverty and lack of access
It won't be easy, but it's a
fight worth fighting. No one should have to suffer in silence or go broke just
to keep their hands steady. By working together and thinking creatively, we can
shake up the status quo and build a future where every Indian with essential
tremor can thrive.
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