Tremor is an unintentional, somewhat rhythmic, muscle movement involving to-and-fro movements (oscillations) of one or more parts of the body. It is the most common of all involuntary movements and can affect the hands, arms, head, face, vocal cords, trunk, and legs. Most tremors occur in the hands. In some people, tremor is a symptom of another neurological disorder. The most common form of tremor, however, occurs in otherwise healthy people. Although tremor is not life-threatening, it can be embarrassing to some people and make it harder to perform daily tasks.
Tremors are unintentional trembling or shaking movements in one or more parts of your body. Most tremors occur in the hands. You can also have arm, head, face, vocal cord, trunk and leg tremors. Tremors are most common in middle-aged and older people, but anyone can have them.
Tremors can happen at any age but tend to be more common in older people.You can develop a tremor from fatigue, stress, anxiety, or even rage. However, an ongoing tremor that is not associated with a change in your emotional state may be a sign of an underlying medical condition and should be evaluated. You may learn, as many do, that your tremors are perfectly normal, but eliminating medical reasons for the shaking is important.
Essential tremor is caused by abnormalities in areas of the brain that control movement and does not occur as the result of disease (e.g., Parkinson's disease). It usually does not result in serious complications.
Parkinson's disease (PD) is a chronic, progressive disorder of the nervous system. A chronic disorder continues for long periods of time, usually many years. Parkinson's disease affects a person's muscular coordination. Symptoms of PD include tremor (shaking), rigidity in some muscles, slow movements, and problems with maintaining normal posture. The disease is caused by the death of cells in one of the movement control centers of the brain. These nerve cells control body movement.
The immediate cause of Parkinson's disease is the destruction of brain cells in a part of the brain known as the substantia nigra (SN). The substantia nigra controls many types of muscular movement by releasing a neurotransmitter called dopamine. A neurotransmitter is a chemical that transports electrical signals between brain cells. Dopamine is needed to carry nerve messages from one brain cell to another.
Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. Tremors may be classified as postural, rest or action tremors. Symptomatic treatment is tailored to the tremor type. Combination therapy with carbidopa and levodopa remains the first-line approach for parkinsonian tremor. Essential tremor may be amenable to propranolol or primidone. Propranolol may be useful in treating alcohol withdrawal tremor, and isoniazid may control the cerebellar tremor associated with multiple sclerosis. Clonazepam may relieve orthostatic tremor.
Early tremors are sometimes treated with anticholinergic drugs which work to restore the balance of the neurotransmitters dopamine and acetylcholine – the former is deficient in Parkinson’s patients whereas the latter is often overactive. However levadopa-based drugs such as Madapor and Sinemet are becoming the mainstay of treatment and have been found to be fast-acting in controlling. They work by converting into dopamine in the brain. Read about drug treatment for PD.
