A tremor is an unintentional, rhythmic movement of one or more parts of the body. Hand tremors are most common, but they can also affect the arms, head, face, voice, torso, and legs. Occasionally, or constantly, tremors can occur.
Tremors can be divided into two categories:
- Resting tremor: It occurs when the muscles are relaxed, such as when the hands are resting on the lap.
- Action tremor: It occurs when a muscle is intended to move
Over 20 types of tremor exist. The most common are:
- An essential tremor usually manifests at both sites of the body and is often more noticeable on the dominant side
- Dystonic tremor occurs due to forceful muscle contractions or cramps caused by spasms in any muscle of the body
- Tremors of Parkinson’s disease, usually in the hands and sometimes in the face, legs, lips, and eyebrows, which cause shakiness at rest.
In general, tremors are caused by problems in the deep parts of the brain that control movement. The cause of some forms of tremor is unknown, while others are inherited. The most common form of tremor occurs in healthy people, but it can also be a sign of another neurological disorder or a side effect of certain medications. An overactive thyroid gland can also cause tremors, as can certain medications, alcohol use disorders, or withdrawal from alcohol. People of all ages may suffer from tremors, but older adults and middle-aged individuals are more likely to suffer from them.
Tremors are generally incurable. Some individuals may not need treatment if their symptoms are mild. It is paramount to diagnose the cause accurately in order to determine the appropriate treatment. Commonly used medications are beta-blocking drugs, anti-seizure medications, tranquilizers, and botulinum toxin injections, as well as medications like levodopa and carbidopa to treat Parkinsonian tremor. Dystonia, essential tremor, and Parkinson’s tremor are commonly treated with deep brain stimulation. People who suffer from tremors should avoid tremor “triggers” such as caffeine and stimulants from their diets. Some individuals may benefit from physical therapy by reducing tremors and improving coordination and muscle control.
Tremors are not life-threatening, however for some people they can be embarrassing to deal with. They can also make it difficult to work, take showers, eat, and dress themselves. In most cases, essential tremor symptoms worsen with age.
To discuss diagnosis and treatment options, please book an appointment with our specialist.
To learn more about tremors, please click on https://www.nhs.uk/conditions/tremor-or-shaking-hands/
Dr Ibrahim Yahli MD MRCPsych