A tremor is an involuntary shaking of a part of the body, often the arms or hands. It occurs when sets of opposite muscle groups contract in turn, producing a rhythmic movement that cannot be controlled. There are three main patterns of tremor: rest tremor, action tremor and functional tremor.
Resting tremor occurs in relaxation. Moving the affected body part can often stop the tremor.
Action tremor occurs when muscles contract to perform a movement, such as writing or holding a glass of water.
Functional tremor is a combination of different types of tremor without a known medical cause. Functional tremors can be improved by distraction with other tasks.
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What causes tremors?
It is normal to have a slight tremor, which might be noticed when carrying out a delicate task or trying to keep the hands outstretched – this is known as a ‘physiological tremor’. However, certain triggers can exaggerate this, including:
- Extreme emotions, such as anger, stress or anxiety
- Caffeine or other stimulants
- Certain medications, such as salbutamol inhalers (for the treatment of asthma)
- Feeling too hot or too cold
- Alcohol or drug withdrawal.
Sometimes a medical condition might be the cause of the tremor, especially if it is getting worse, or if it’s beginning to have an impact on everyday life. Examples of such medical conditions are described below.
This is the most common cause of action tremors, affecting as many as 1 in 17 people. It is a medical condition often passed on in families; although it can appear at any age, it becomes more likely in older age. There are no other symptoms present with an essential tremor.
Low blood sugar
Episodes of low blood sugar or ‘hypos’ may occur in people with diabetes who take insulin or other medications that lower blood sugar. As well as a tremor, the patient may experience nausea (feeling sick), sweats, hunger and poor concentration.
Overactive thyroid gland
An overactive thyroid gland can lead to the overproduction of thyroid hormones. This can cause a feeling of being shaky, weight loss, diarrhoea, breathlessness and anxiety.
How are tremors diagnosed?
If there are concerns about a persistent tremor, then one of our specialist doctors here at The London Clinic Centre for Movement Disorders will be able to help assess and diagnose the tremor.
They will ask questions about the symptoms, such as where and when the tremor started, whether it comes and goes, and if it is present at rest or during activity.
This information, along with a careful physical assessment, can help to determine the type and cause of the tremor. The specialist may also wish to perform some MRI scans of the brain and blood tests.
What are the common treatments for tremors?
If the tremor is a ‘physiological tremor’, then treatment will aim to help identify and avoid the triggers. Reducing caffeine intake or changing the dose of certain medications may help to relieve symptoms. Cognitive behavioural therapy, a form of focused psychotherapy, can help to reduce the effects of anxiety and stress, which may also help.
If the tremor is caused by an underlying medical condition, such as Parkinson’s disease or an overactive thyroid gland, then treatment is focused on managing that effectively.
For the management of essential tremor, medications can be effective. In more severe cases, an innovative surgical procedure known as deep brain stimulation may be offered.
This involves inserting small wires called electrodes into the region of the brain responsible for the tremor. The electrodes are connected to a small electrical device that sits under the skin. A painless electrical impulse is delivered through these electrodes to block the signals causing the tremor and so the muscles in question relax.
Why choose The London Clinic?
At The London Clinic, we are committed to delivering quality, patient-centred care. At our state-of-the-art facilities, we offer access to a full multidisciplinary team comprising expert specialists in the field of movement disorders, and clinical support teams that are second to none.