Tremor Specialist

What is a tremor?

A tremor is an unintentional, rhythmic muscle movement causing involuntary spasms. Most tremors affect the hands but they can also occur in the arms, head, face, voice, trunk, and legs. In some people, tremor can be a sign of a neurological disorder, or it can appear as a side effect of certain drugs. Characteristics of a tremor may include:

• A rhythmic shaking in the hands, arms, head, legs, or trunk

• Shaky voice

• Difficulty writing or drawing

• Problems holding and controlling utensils

What causes a tremor?

Tremors commonly occur due to problems in parts of the brain that control muscle movement throughout the body. Neurological disorders or conditions that can produce tremor include:

• Multiple sclerosis

• Stroke

• Traumatic brain injury

• Neurodegenerative diseases that damage or destroy parts of the brainstem or the cerebellum.

• Use of certain drugs

• Alcohol abuse or withdrawal

• Mercury poisoning

• Overactive thyroid

• Liver failure

Some forms of tremor are inherited and run in families, while others have no known cause. Tremor may occur at any age but is most common in middle-aged and older people.

What are the treatments?

There is no cure for most tremors. Treatment will depend on diagnosing the exact cause of the tremor. This involves a physical exam where the doctor can determine whether the tremor occurs primarily during activity or at rest. A resting tremor occurs when the muscle is relaxed, such as when the hands are lying on the lap where an action tremor occurs during any type of movement of an affected body part. A detailed family history may indicate if the tremor is inherited. Some tremors respond to treatment of the underlying condition. Symptomatic drug therapy is available for several forms of tremor. Eliminating tremor "triggers" such as caffeine and other stimulants from the diet is often recommended. Physical therapy, such as coordination and balancing exercises, may help to reduce tremor symptoms and improve coordination and muscle control for some individuals.