Tremors

Tremor is the most common movement disorder and may involve any part of the body, but typically affects the hands, head and voice.  Tremor is a symptom and not a diagnosis and may be due to different causes including side effects of medications, problems with thyroid function, or an underlying neurologic disease such as Parkinson’s disease.

The most common cause of tremor is known as essential tremor and tends to run in families.  Essential tremor causes tremor while holding objects such as a cup or fork and also tends to occur while performing an action such as handwriting or moving the hand.  It may also affect the head or voice.  Essential tremor is treated with medications such as Propanolol, a beta blocker, or Primidone, an anticonvulsant medication.  If severe and refractory to medication treatment, a deep brain stimulation (DBS) surgery can be performed to improve symptoms.

Tremor with Parkinson’s disease tends to occur while the hands are at rest and not performing any activity. Parkinson’s disease tends to be associated with additional symptoms beyond tremor, including slowing of movements, stiffness and difficulty with walking.  However, there is some uncertainty with initial diagnosis, so if you have tremor, evaluation by a neurologist is recommended.

Tremor that is refractory to medication therapy in Parkinson’s disease or essential tremor may be amenable to surgical treatment with deep brain stimulation.  In addition, focused ultrasound (FUS) is a new treatment option in patients with essential tremor.

Tremor Patient Resources

International Essential Tremor Foundation - http://www.essentialtremor.org

Tremor Action Network - http://tremoraction.org

Liftware – Utensils that help reduce tremor during meals – http://www.liftware.com

Deep Brain Stimulation for Essential Tremor - http://www.medtronicdbs.com/essential-tremor/

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