A tremor is an involuntary muscle movement characterized by shaking of a body part, usually the hands and arms, and difficulty holding and controlling objects. It may also involve other parts of the body such as the vocal cords and head. A slight tremor is normally present in all of us, especially the elderly. It increases when we are angry, fearful, under stress, fatigued, smoke, drink a lot of caffeine or as a response to certain medications.
Tremors due to a neurological disease that do not resolve require medical intervention. Neurological causes of tremors may be due to conditions such as Parkinson’s disease and dystonia (a movement disorder); damage to the cerebellum (the lower part of the brain) due to stroke, tumour or disease; psychological disorders; and alcoholism. Tremors occur due to problems in regions of the brain that control muscles.
Tremors may be resting tremors, which occur in a body part at rest, as seen in Parkinson’s disease, or action tremors, which may occur when holding a body part against gravity or performing a task.
When you present with tremors, your doctor reviews your medical history and performs a physical examination to determine the characteristics of your tremor and if there is any underlying disease. Blood, urine and imaging tests such as CT or MRI scans may be performed. Neurological tests and electromyography may be ordered to assess motor and sensory skills.
Tremors can improve with the treatment of the underlying cause. Therapies may include:
- Reduction or stoppage of medications causing tremors
- Physical therapy to improve muscle coordination and control
- Surgery if the symptoms are severe and conservative options fail
- Avoidance of alcohol and caffeine which may be triggers