BET is an action tremor where the patient experiences tremor while attempting to do a specific action such as writing, eating or drinking. The tremor is typically worse when the patient is anxious and in public gathering, betters when at home or relaxed. The tremor is typically hereditary, running in the family.
BET is a disease of its own, completely unrelated to Parkinson disease. It is benign, as the name states and harmless, yet annoying. The diagnosis is based on clinical history and examination. There is no specific test that confirms it or rule it out. The tremors, however, if there are other associated symptoms require an MRI of the brain.
There is no cure for BET; however, treatment is used to suppress the tremors. Treatment is initiated when the tremors are interfering with the activities of daily living and become embarrassing to the patient. Commonly used medications are primidone (Mysoline), propranolol (Inderal) and occasionally topramate (Topamax). When tremors are extremely severe and fail medications, patient might consider deep brain stimulation. We manage and program the deep brain stimulators in our office after a local neurosurgeon implants it.