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Essential tremor
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===Poisons and toxins=== Some environmental [[poison]]s, including [[toxin]]s, are also under active investigation, as they may play a role in the disease's cause.<ref>{{cite journal | vauthors = Louis ED | title = Etiology of essential tremor: should we be searching for environmental causes? | journal = Movement Disorders | volume = 16 | issue = 5 | pages = 822โ829 | date = September 2001 | pmid = 11746611 | doi = 10.1002/mds.1183 | s2cid = 38809483 }}</ref> Exposure to heavy metals, specifically [[lead]], has been associated with causation of ET.<ref name=":3" /><ref>{{cite journal | vauthors = Dogu O, Louis ED, Tamer L, Unal O, Yilmaz A, Kaleagasi H | title = Elevated blood lead concentrations in essential tremor: a case-control study in Mersin, Turkey | journal = Environmental Health Perspectives | volume = 115 | issue = 11 | pages = 1564โ1568 | date = November 2007 | pmid = 18007985 | pmc = 2072853 | doi = 10.1289/ehp.10352 | bibcode = 2007EnvHP.115.1564D }}</ref> Lead is a heavy metal that can cross the [[central nervous system]]'s (CNS) main line of defense, the [[bloodโbrain barrier]], even increasing its permeability, allowing other harmful substances to access the CNS.<ref>{{cite web |title=Chronic Lead Exposure: A Non-Traumatic Brain Injury |url=https://www.biausa.org/public-affairs/public-awareness/news/chronic-lead-exposure-a-non-traumatic-brain-injury |website=Brain Injury Association of America |access-date=2024-08-02}}</ref> This allows lead access to the CNS, permitting it to disturb processes that utilize calcium, including synaptic activity, and causes intracellular disruption, both of which may lead to irreversible damage to the CNS.<ref>{{cite journal | vauthors = Marambaud P, Dreses-Werringloer U, Vingtdeux V | title = Calcium signaling in neurodegeneration | journal = Molecular Neurodegeneration | volume = 4 | issue = 1 | pages = 20 | date = May 2009 | pmid = 19419557 | pmc = 2689218 | doi = 10.1186/1750-1326-4-20 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Sanders T, Liu Y, Buchner V, Tchounwou PB | title = Neurotoxic effects and biomarkers of lead exposure: a review | journal = Reviews on Environmental Health | volume = 24 | issue = 1 | pages = 15โ45 | date = January 2009 | pmid = 19476290 | pmc = 2858639 | doi = 10.1515/REVEH.2009.24.1.15 }}</ref> This would include cerebellar damage which could cause ET. There are other poisons that work in a similar manner to lead such as other heavy metals like mercury and aluminum, as well as toxic chemicals like certain pesticides and alcohol. In particular, excessive alcohol consumption can worsen essential tremor due to damage to the cerebellum.<ref>{{cite journal | vauthors = Luo J | title = Effects of Ethanol on the Cerebellum: Advances and Prospects | journal = Cerebellum | volume = 14 | issue = 4 | pages = 383โ385 | date = August 2015 | pmid = 25933648 | pmc = 4492805 | doi = 10.1007/s12311-015-0674-8 }}</ref>
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