German Chancellor, Angela Merkel has been seen shaking during a public event for the second time in eight days.
In the below twitter thread by a United Kingdom based Nigerian Doctor, Harvey Olufunmilayo, speculates what could be causing the symptoms.
Despite having held Germany’s highest office for the past 14 years, she barely ever shows signs of stress and is known among colleagues for rarely, if ever, taking a sick day.
Which made it all the more concerning when Merkel was filmed visibly shaking during a military ceremony welcoming the new Ukrainian president to Berlin on Tuesday.
She and her team had blamed the previous incident on dehydration.
Eight days after the first incident, video shows the 64-year-old German leader trembling once again during a ceremony in Berlin on Thursday.
Video showed Merkel gripping her arms as her body was shaking on Thursday. After about two minutes, she looked steadier and shook hands with the new justice minister.
She later set off for the G20 summit in Japan as planned at lunchtime.
“All is going ahead as planned. The federal chancellor is fine,” spokesman Steffen Seibert said.
See Dr Olufunmilayo thread…
Sadly, What Angela Merkel has is a medical condition called Benign Essential Tremor. This explains the quite small, rapid shaking of both hands, forearms and even body trunk (if you look well enough).
So what is Benign Essential Tremor? It’s a brain/nerve disorder that causes unplanned uncontrollable shaking motion of different parts and sides of the body. It can affect hands, arms, head, voice, tongue and even the chin. It is not a life threatening illness thankfully.
Essential Tremor only becomes an issue when the person has to do activities like eating, dressing or writing. And if it gets very severe, then the Tremor may cause the person to be unable to care effectively for themselves. This is the only time it’s regarded as a disability.
Essential Tremor is medically defined as either an “action tremor”- means it gets intensified when the person tries to use the affected body part; Or a “postural tremor”- which is present when a person has to maintain a particular posture for a long time- like this Merkel case.
Because she has to stand for a long time, at that programme, with her hands carefully sustained in that position, if you noticed- both hands as well as her trunk started to shake and vibrate uncontrollably- That’s very suspicious of essential tremor. And not Parkinson’s disease.
So what causes Essential Tremor? The actual cause is unknown. But doctors believe it’s a result of abnormal electrical brain activity (processed in the part of the brain called the thalamus). However in about 50% of all the people with essential tremor, it runs in the family.
A child born to a parent with Essential Tremor has up to 50% chance of having the genetic problem believed to be responsible for the condition. Even though this doesn’t also automatically mean they may actually ever have the symptoms. It’s actually quite a common illness.
In the USA alone, it’s estimated over 7million people have Essential Tremor. Its commoner in elderly people from 60s and above- up to 20% of those in 90s- compared to just 4% of people in their 40s or younger. However I should clarify that Essential Tremor is not part of aging.
Clearly other things can cause uncontrolled shaking like alcohol abuse, an overactive thyroid, a stroke, and different types of neurological conditions. However, all these kind of tremors aren’t characterized as essential tremors. If there’s a clear cause, it’s not seen as E.T.
How is E.T diagnosed? It’s usually clinical without needing any tests. Doctors just see you and examine you to assess the severity. If any tests or scans are done, it’s to rule out any possible alternative explanations for the tremor like brain tumour or Parkinson’s disease.
Is there a cure or treatment? Yes, there’s treatment. But no, there’s no cure. The symptoms can be ignored if very mild. It can be treated with medications if quite worrisome. But there’s no medical cure for the disease itself. I hope you get the distinction I’m making here.
If everything else fails, some people may consider Botox injections to weaken the affected muscles and reduce the tremors, or a brain surgery- but this is a last resort. But if the impact on the person’s life is not very severe, there’s no need for any intervention then.
Infact one example that readily comes to mind is the actress Katherine Hepburn, famous for having a successful acting career winning four Oscar Awards despite inheriting Essential Tremor from her grandfather. So people with Essential Tremor can live very normal productive lives.
For those asking, yes Parkinson disease is a sensible possibility in this case. I admit that. But I have reasons to think this is more of E.T than Parkinson’s. I would explain. Her gait and balance is intact- people with Parkinson’s tend to have gait and balance issues.
Parkinson’s tremors tend to be very obvious, slow frequency and high amplitude. Essential Tremors though tend to have fast tremors that you may not even notice. If you watch that video again, you will never notice her tremors until the camera zoomed in on her arms and body.
Also, Parkinson’s tremors tend to start from one side of the body and progress to the other part. However essential tremors tend to happen to both sides of the body symmetrically at the same time. That’s what happened in this video.