Essential Tremors: How This Condition Led to a Signature Mismatch

Recently in Hyderabad, a person's cheque was canceled due to a signature mismatch, which led to the diagnosis of a health condition.
Dr. Sudhir states in his tweet that the salient observations are that the patient experienced shaking hands only when he engaged in activities, such as holding an object or attempting to write, with no tremors at rest. (representational image: Unsplash)
Dr. Sudhir states in his tweet that the salient observations are that the patient experienced shaking hands only when he engaged in activities, such as holding an object or attempting to write, with no tremors at rest. (representational image: Unsplash)

Nowadays, we ask Google about everything: the places to visit, the places to dine, study, and shop. We are also using it for self-diagnosis of diseases; sometimes the results are not as you foresee, and it causes suspicion. Recently in Hyderabad, a person’s cheque got canceled due to a signature mismatch. Both of his hands had been shaking for the past six months, and he was unable to hold a cup of tea while drinking. When the cheque got canceled, he was panicked about his health. He Googled his symptoms, and it further raised his fright. His extensive research on Google showed that his condition is Parkinson's disease based on the symptoms.

Dr. Sudhir Kumar is a Hyderabad-based doctor who treated him. He says that when Mr. Jasprit (name changed), a 30-year-old, visited the hospital, he asked me to give him the best medication for the treatment of his Parkinson's disease (PD). But I requested that he stay calm while taking a detailed history and clinically examining him. “After examining his symptoms, it was concluded that he was diagnosed with essential tremors, not PD."

This Hyderabad doctor on his X (formerly Twitter) handle made a tweet about this situation, showing how a minute change led to a diagnosis of a condition called’ Essential Tremors’. Dr. Sudhir says in his tweet that salient observations are that the patient had shaking hands only when he acted, such as while holding an object or while trying to write, and there were no tremors at rest. He walked usually, and there was no slowness of movement. There was no immobility or rigidity of limbs while trying to move them. There were no balance issues while walking or turning. These clinical features were hallmarks of another disease, not PD. My explicit diagnosis was essential tremors (ET).

In essential tremors (ET), tremors occur while doing an activity, whereas in PD, tremors occur while resting (representational image: Unsplash).
In essential tremors (ET), tremors occur while doing an activity, whereas in PD, tremors occur while resting (representational image: Unsplash).

Dr. Sudhir Kumar also elucidates the difference between essential tremors (ET) and Parkinson's Disease (PD) in his tweet.

  • In ET, tremors occur while doing an activity, whereas in PD, tremors occur while resting

  • People with PD have other symptoms such as slowness of movements, rigidity of limbs, and loss of balance. These symptoms are absent in ET

  • Generally, ET affects both hands from the beginning, whereas PD starts in one hand, and after a long gap, the other side may also get affected.

  • The deterioration in symptoms is more prompt in PD than in ET 

The doctor counseled Mr. Jasprit about the condition and its long-term outcome. And they discussed the treatment options, but Mr. Jasprit decided to wait and watch for any progression of symptoms before starting medicine. And said Mr. Jasprit was much relieved now.

The doctor gave a take-home message: shaking of hands is not always due to PD, and excellent treatment options are available for treating ET.

(Rehash/Lavanya Beeraboina)

Dr. Sudhir states in his tweet that the salient observations are that the patient experienced shaking hands only when he engaged in activities, such as holding an object or attempting to write, with no tremors at rest. (representational image: Unsplash)
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