Nervousness and suffering from a diseases both can be reason behind a tremors one might experience. Although, both are involuntary, tremors due to diseases result from a neurological damage and be difficult to manage.Tremor is a type of unintentional, shaking movement which can be due to a neurological disorder or as a side effect of certain drugs or maybe the cause is not yet known. This condition affects mostly the hands, but can also affect other body parts including the head and voice.

Although most tremors are not life threatening, they do negatively affect the quality of life.

There are many types of tremors depending upon the nature of the involuntary movements and their sources. Let’s categorize them as follows.

  1. Resting tremors – These tremors occur when your muscles are resting, and when you move those muscles the tremors may disappear or become less noticeable. Example, Parkinson’s disease.
  2. Action tremors – These tremors occur when you are intentionally or purposefully moving the muscle of the body part, such as, when you are writing, pushing a button, or you are reaching for an object. Example, multiple sclerosis. Action tremors are again of two types – postural tremor, and kinetic or intention tremor.
  3. Idiopathic tremors – This is a type of tremor that has developed spontaneously or due to an unknown cause. Example, Idiopathic Dystonic Tremor.

Parkinsonian tremor (resting tremor)

Parkinson’s disease is a progressive neurological condition which currently has no cure. The chemical dopamine helps regulate and control movement in the body. In people with Parkinson’s, nerve cells responsible for dopamine production die or produce insufficient dopamine and this causes the symptoms of Parkinson’s to appear.  Parkinson’s disease mostly affect people aged 50 or more, but can be seen in younger people too. You may like to read about a new device designed to beat trembling associated with this disease.

Tremors seen in Parkinson’s disease are typically the first sign of the condition. Other symptoms include slowness of movement and stiffness. However, not everyone will experience these symptoms. Tiredness, pain, depression, and constipation are other symptoms of the disease. You may also like to read about 10 facts about Parkinson’s.

Tremor, in most cases, starts in the fingers of the hand, spreads to the arm, and from there to the foot on the same side of the body. Normally parkinsonian tremors affect one side of the body, but may start affecting the other side too after several years. Parkinson’s diseases can be managed effectively with yoga.

Symptoms: The tremor begins in the fingers of one hand, spreading to the arm and then to the foot on the same side of the body. Tremors are not as fast as seen in Essential tremor and tend to reduce or stop when the affected part is moved; levodopa drug may reduce tremor associated with Parkinson’s.

Possible triggers: Stress and depression worsen the symptoms of Parkinson’s.

Clue to Parkinsonian tremor:

  1. The typical tremor resemble ‘pin rolling’ as in rolling of a cigarette or coin between thumb and index finger.
  2. The tremor affects one side of the body in the early stages.
  3. Tremor begins in the fingers of one hand spreading to arm and then the foot. 

Postural tremor (action tremor)

Postural tremor is a form of action tremor that occurs when the limb or the whole body is supported against the gravity. For example, a person with this condition will be shaking when sitting or standing but will not shake while lying down. This type of tremor is mostly seen in people with multiple sclerosis (MS). Intention tremor also occurs in MS.

Symptoms:  Tremor of the upper limbs can be very disabling and seriously impair many activities of daily living and quality of life in people with MS. Tremor ranges from severe to minimal. Head, neck, vocal cords, trunk and the limbs are normally the body parts affected. Read more about multiple sclerosis.

Possible triggers: Stress, anxiety or fatigue; sometimes overactive thyroid can also cause the tremor.

Clue to MS tremor:

  1. The tremor in MS almost always occur with associated symptoms such as difficulty in speaking and swallowing, and jumpy eye movements (nystagmus).
  2. MS tremors is commonly seen in both arms.

Cerebellar tremor (Intention tremor)

People with multiple sclerosis also show a type of tremor called cerebellar tremor or intention tremor. This type of intention tremor is caused when the cerebellum (part of the brain) is damaged from stroke, tumour, or MS and other degenerative disorders.

Symptoms: The tremors are generally a combination of rest, action, and postural tremors.

Possible triggers: Excessive alcoholism, overuse of certain medicines

Clue to cerebellar tremor:

  1. The tremor is typically a ‘wing beating’ type of tremor, that is, broad, coarse and low rapidity.
  2. A lesion on one side of the brain produces a tremor in that same side of the body that worsens with directed movement.

Essential tremor

Essential tremor, a pretty common condition, is a nervous system disorder that involves rhythmic shaking of affected body parts, especially the hands, though the legs, arms and head can also be affected. The condition is almost always genetic and runs through families. You may have a 50 percent chance of inheriting the condition from your parent. And the condition aggravates if you are anxious or nervous and becomes much more noticeable.

Essential tremor can occur at any age; though it is more commonly seen in older people, it can begin as early as birth. Both genders are affected equally and the condition can occur across any race.

Scientists have confirmed that it is a disorder of the central nervous system but what part of the brain is involved is not yet known. This is the reason, the condition is termed idiopathic, that is, no known reason for the occurrence.

Symptoms: Shaking of hands, especially when in use; shaking or nodding of head as in ‘yes’ or ‘no’ motion; quivering speech; mild, rhythmic, fast tremors, that worsens with age.

Possible triggers: Emotional stress, social interaction, alcohol, caffeine, insufficient sleep, extreme temperature. Sometimes, however, small amount of alcohol may be helpful if the tremors occur during stress and social interaction.

Clue to essential tremor:

  1. Your hands shake when they are in use, for example, while holding something or writing; and stop when they are not in use.
  2. Almost always genetic.
  3. Mostly affects the hands.
  4. Rhythmic fast tremors.

Other categories of tremor are:

Orthostatic tremor

Orthostatic tremor is considered to be a variant of essential tremor. This type of tremor occurs in the legs immediately on standing and is relieved by sitting down. This type of tremor is usually very vigorous. No other symptoms are present.

Psychogenic tremor

Psychogenic tremor are common in psychiatric disorders such as depression or anxiety.  Tremor can involve any part of the body, but it most commonly affects the extremities. Usually, tremor onset is sudden and begins with an unusual combination of postural, action, and resting tremors. Psychogenic tremor decreases with distraction and is associated with multiple other psychosomatic complaints. 

Task specific kinetic tremors, also called occupational tremors, happen or become vigorous only when you are doing a specific task such as writing or any act which mimics writing.

Dystonic tremor

Dystonia is a condition in which there is an increased activity of certain muscles wherein they contract of their own accord resulting in body parts adopting abnormal postures. This can cause lot of pain and discomfort.

Dystonic tremor generally occurs in people who are in the 20 to 30 age group or in people in 50-70 age group.

This category of tremor can affect multiple body parts, but commonly head and hands and occasionally voice.

  • Dystonic hand tremor is a cramp-like sensation while performing tasks such as writing. It may cause you to rub your palms to relieve the pain.
  • Dystonic head tremor tends to cause the head to shake in a ‘no-no’ motion or sometimes in a ‘yes-yes’ motion. This may sometimes cause the head and neck to tilt to one side, backwards or forwards.
  • Dystonic voice tremor occurs when the muscles of the voice box (larynx) are affected, altering the tone of your voice and cause it to fluctuate while talking.

Enhanced physiologic tremor

Physiologic tremor occurs in every body and can be brought on by strong emotions, hypoglycaemia, and hyperthyroidism. Other causes can be –

  • Side effects of drugs such as amphetamines, corticosteroids, and some drugs used to treat certain psychiatric disorders.
  • Stress, fatigue.
  • Alcoholism or alcohol withdrawal.
  • Too much caffeine.
  • Aging and general muscle tiredness.

But this type of tremor is not visible to the eye. Enhanced physiologic tremor is a stronger type of physiologic tremor and is visible. The good part is, the condition is reversible once the cause of the tremor is corrected.

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