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Tremor
Definition:
Tremors are a type of involuntary shaking movement.

Causes, incidence, and risk factors:

Tremors are caused by problems with the nerves supplying certain muscles. They can affect the whole body or just certain areas (such as hand tremor).

Disorders where tremor is the primary symptom include:

  • Familial tremor (runs in families)
  • Essential tremor (no known cause)
  • Drug-induced tremor (drugs known to induce tremor include valproic acid, lithium, and cyclosporine)
Parkinson's disease and other illnesses may cause tremors in addition to other symptoms.
Symptoms:
  • Tremors
    • May be occasional (sporadic), temporary (episodic) or occurring at intervals (intermittent)
    • Occur at a rate of about 6-10 tremors per second (when tremors are occurring)
    • May affect the head, hands, arms, eyelids, or other muscles
    • Do not usually affect the lower body
    • May not affect both sides of the body equally
  • A shaking or quivering sound to voice
  • Head nodding
  • Tremors worsen with voluntary movement or emotional stress
  • Tremors disappear during sleep
Signs and tests:
Tests depend on the suspected cause of the tremor. However, a neurologic examination should be conducted in most cases.
Treatment:

Treatment may not be required if the tremors are mild and do not interfere with daily activity. If the tremors are drug induced, stopping the medication is usually sufficient. (Never stop a medication without a doctor's supervision.)

The success of medications to treat tremor varies; it depends on individual response. Medications that may reduce tremors include propranolol, Mysoline and other anticonvulsants, and mild tranquilizers. Caffeine (in substances such as coffee and soda) and other stimulants should be avoided because they commonly worsen tremors.

If tremor is severe and not responsive to medication, surgery may be helpful.
Expectations (prognosis):
See the specific disorders.
Complications:
If severe, tremors can interfere with daily activities, especially fine motor skills (such as writing). Speech is occasionally involved. Medications can cause side effects.
Calling your health care provider:
See your health care provider if you have a persistent, unexplained tremor or if tremors are interfering with your ability to perform daily activities.
Review Date: 11/14/2002
Reviewed By: Elaine T. Kiriakopoulos, M.D., M.Sc., Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
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