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Tremor
Definition:
Tremors are a type of 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)
Other disorders, such as Parkinson's disease, as well as other illnesses may cause tremors along with other symptoms.
Symptoms:
  • Tremors
    • May be occasional (sporadic), temporary (episodic),or occurring at intervals (intermittent)
    • Occur at a rate of about 6 to 10 tremors per second (when tremors are occurring)
    • May affect the head, hands, arms, eyelids, or other muscles
    • Does 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.
Treatment:

Treatment may not be required if the tremors are mild and do not interfere with daily activity. If tremors are thought to be drug induced, cessation of the offending medication is usually sufficient to stop the tremor.

Medications to treat tremor are variable because of individual responses to medications. 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 performed to reduce tremor.
Expectations (prognosis):
See the specific disorders.
Complications:
If it is severe, tremors can interfere with activities, especially fine motor skills (such as writing). Speech is occasionally involved. Medications can cause side effects.
Calling your health care provider:
Call for an appointment with your health care provider if you have a persistent, unexplained tremor; or if tremors are interfering with your ability to perform daily activities.
Prevention:
See the specific disease.
Review Date: 7/24/2001
Reviewed By: Galit Kleiner-Fisman MD, FRCP(C), Department of Neurology, University of Toronto, Toronto, Ontario, Canada. Review provided by VeriMed Healthcare Network.

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