Tremors

A tremor is defined as the unintentional or uncontrollable movement of a part of the body. 

Tremors are sometimes the result of movement disorders, neurological conditions, or other health problems.

There are two types of tremors: resting and action. Resting tremors mostly affect the hands or fingers. They occur when a person is sitting still and tend to go away once an individual begins to move around. Action tremors occur when there is movement of the affected part of the body.

In addition to type, tremors can be further categorized by their appearance and cause. These categories include:

  • Essential tremor- results from a neurological disorder that causes the hands or other parts of the body to shake involuntarily and rhythmically.  Shaking typically tends to worsen during movement than when at rest.
  • Dystonic tremor- occurs in individuals with dystonia, a movement disorder characterized by involuntary muscle contractions. Dystonia causes repetitive or twisting movements.
  • Parkinsonian tremor- is a common symptom of Parkinson’s disease.  Tremors occur mostly at rest. Involuntary and rhythmic tremors often start in one side of the body and eventually progress to both sides.
  • Cerebellar tremor- is caused by lesions or damage to the cerebellum from a tumor, stroke, or diseases such as multiple sclerosis.  Cerebellar tremors can also be caused by inherited degenerative disorders such as ataxia as well damage to the cerebellum resulting from chronic alcoholism.
  • Orthostatic tremor- is a movement disorder characterized by a rapid tremor in the legs that occur when standing.
  • Psychogenic tremor- is the most common psychogenic movement disorder. It occurs often in patients who have conversion disorder. According to the National Institutes of Health, “Conversion disorder is a disorder in which a person experiences blindness, paralysis, or other symptoms affecting the nervous system that cannot be explained solely by a physical illness or injury. Symptoms usually begin suddenly after a period of emotional or physical distress or psychological conflict.”  Many patients with psychogenic tremors have underlying psychiatric disorders such as post-traumatic stress disorder or depression.
  • Physiologic tremor- is barely visible to the naked eye and is typically reversible once the cause is corrected.  It can become more pronounced when there is a reaction to certain drugs, alcohol withdrawal or medical conditions such as hypoglycemia or hyperthyroidism. These tremors may also present during periods of muscular fatigue, anxiety, or emotional stress.

Tremors can be diagnosed during a physical examination.  Your doctor may order urine, blood or neurological tests to check for underlying medical conditions.

Tremors are treated based on the underlying cause and may include physical therapy, psychotherapy Botox injections, medications or surgery.