A tremor is a neurological condition that causes shaking or trembling in one or more parts of the body, most often the hands, but also the arms, legs, head, vocal cords or trunk. It is involuntary, caused by muscle contractions you cannot control. It may come and go or be constant, and may occur on its own or because of another disorder. It is not life-threatening, but it can make everyday tasks such as writing, typing, eating and dressing hard, and sometimes leads to disability.
Types
| Type | What it is |
|---|---|
| Essential tremor (benign essential or familial tremor) | the most common type; usually affects both hands and arms during movement, and sometimes the head, voice or legs |
| Parkinsonian tremor | a common symptom of Parkinson's disease; usually one or both hands at rest, sometimes the chin, lips, face and legs |
| Dystonic tremor | occurs with dystonia, a movement disorder of involuntary contractions that cause twisting, repetitive movements in any muscle |
Causes
Tremor usually stems from a problem in the deep parts of the brain that control movement. For most types the cause is unknown, and some run in families. Other causes include:
- neurological disorders: multiple sclerosis, Parkinson's disease, stroke, traumatic brain injury;
- some medicines: asthma drugs, chemotherapy, corticosteroids, and some psychiatric and neurological drugs;
- alcohol use disorder or alcohol withdrawal;
- poisoning by toxic substances such as pesticides, mercury or lead;
- an overactive thyroid (hyperthyroidism);
- liver or kidney failure;
- anxiety or panic;
- too much caffeine.
Anyone can develop a tremor, but it is most common in middle-aged and older adults, and for some types a family history raises the risk.
Symptoms
Rhythmic shaking of the hands, arms, head, legs or trunk; a shaky voice; difficulty writing or drawing; trouble holding and controlling utensils such as a spoon.
Diagnosis
A health care provider may use:
- a medical history and physical exam, noting whether the tremor happens at rest or in action, where it is, how often and how strong;
- a neurological exam, checking for balance and speech problems and muscle stiffness;
- blood or urine tests to find a cause, and imaging to look for brain damage;
- tests of everyday tasks, such as handwriting or holding a fork or cup;
- an electromyogram, which measures involuntary muscle activity and muscles' response to nerve stimulation.
Treatment
Most tremors cannot be cured, but symptoms can be managed, and very mild ones may need no treatment. The right treatment depends on the right diagnosis: a tremor caused by another condition may improve when that is treated, and one caused by a medicine usually goes away when the medicine is stopped.
- Medicines, specific to the type of tremor, and Botox injections, which treat several types.
- Surgery for severe tremor that medicines don't help, most often deep brain stimulation, in which implanted electrodes send electrical pulses to the parts of the brain causing the tremor.
- Physical, speech-language and occupational therapy, to help control the tremor and cope with daily challenges.
- Cutting out caffeine and other stimulants, if they set off your tremor.
Sources
- MedlinePlus, U.S. National Library of Medicine, "Tremor," from the NIH National Institute of Neurological Disorders and Stroke. https://medlineplus.gov/tremor.html
- Rewritten in hubnx's own words.
许可协议： CC0 1.0（公有领域） · 改编自 medlineplus.gov
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