In light of International Essential Tremor Awareness Month, our team have decided to dedicate our most recent blogpost to our veterans.
Veterans are affected by tremors due to many different reasons, ranging from tremors being caused from PTSD to exposure of certain environments causing them to develop diseases such as Parkinson’s Disease (PD) after a while. The most common cause is post-traumatic stress disorder (PTSD), distressing symptoms occur after one or more frightening incidents. For the most part, a person with this disorder must have experienced or witnessed a traumatic event. The event must have involved serious physical injury or the threat of serious injury or death. The associated symptoms vary in intensity, ranging from mild and tolerable anxiety to a full-blown panic attack. Symptoms include sweating, shortness of breath, pounding heart, dry mouth, and tremor. Some war veterans suffering from PTSD have a problem with alcohol and smoking cigarettes. It is twice as likely for someone with PTSD to smoke than those without PTSD. Withdrawal of these substances can cause tremors.
Furthermore, another cause of tremors in veterans is a traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force traumatically injures the brain. TBI can be classified based on severity, mechanism. Head injury usually refers to TBI, but is a broader category because it can involve damage to structures other than the brain, such as the scalp and skull leading to veterans suffering from tremors. Given the nature of combat in Iraq, Afghanistan, Somalia, etc., very few Veterans escape combat service without a TBI – or Traumatic Brain Injury. It has been estimated that about 300,000 OIF/OEF Vets, about 15%, have a diagnosed or untreated Traumatic Brain Injury (TBI).
Another cause of tremors in veterans is the exposure to certain chemicals in combat. For example, during the Vietnam war a mixture of toxins was used to remove leaves from trees in order to leave the enemy exposed. Around 2.6 million soldiers were exposed to this chemical. Exposure to this chemical has been known to be tied to many diseases including PD, cancer, and diabetes. Veterans exposed to Agent Orange have a 70% greater likelihood of being diagnosed with Parkinson’s disease. Additionally, from 1955-1975 researchers at Edgewood used human subjects instead of animals to test a variety of drugs and chemicals. Subjects used in these test have experienced PD later in life. Similarly, Gulf War veterans were exposed to a class of chemicals called Acetylcholinesterase inhibitors, a chemical which affects numerous bodily functions. Side effects can include muscle twitching, cramps, weakness, tremors, paralysis, fatigue, mental confusion, headache, poor concentration, and general weakness. Additionally, a newly identified disorder called Gulf War illness (GWI) has affected close to 30 percent of the military personnel who served in the 1990-1991 Persian Gulf War.
Researchers at Georgetown University have identified two distinct forms of GWI where the veterans’ brains have actually atrophied, or died from over use. Symptoms of these veterans include cognitive impairment, widespread aches and pains, and tremors.
In 2001, the Department of Veteran Affairs (VA) created six specialized centers known as the Parkinson’s Disease Research, Education and Clinical Centers or “PADRECCs”. These Centers of Excellence are designed to serve the estimated 80,000 veterans affected by PD through state-of-the-art clinical care, education, research, and national outreach and advocacy. The PADRECCs are staffed by internationally known movement disorder specialists, neurosurgeons, psychiatrists, psychologists, nurses, researchers, educators, social workers, and other PD experts.
The PADRECCs offer care to all veterans currently enrolled in the VA Healthcare System. This includes veterans who have been previously diagnosed with PD or veterans who have just started to notice Parkinson-like symptoms. They also treat veterans who have been diagnosed with other movement disorders, such as essential tremor.
As always, we welcome anyone to comment their anecdotes with the above topic or to ask for further advice on how to handle it.