Do you shake?
Shaking or in medical terminology, a tremor, is the unintentional, rhythmic, back and forth movement, of one or more body parts. It is most commonly seen in the hands and depending on the reason for the tremor, it may be seen at rest or on activity. The most common form of tremor occurs in healthy people and can cause embarrassment and interfere with the ability to carry out daily tasks.
What causes a tremor?
There are many causes of a tremor. It is generally caused by a disorder in a part of the brain involved in the control of movement throughout the body or in a specific area such as those controlling the hands. Neurological conditions which can have symptoms of tremor include multiple sclerosis, stroke, traumatic brain injury and neuro-degenerative diseases affecting the brain stem or cerebellum. A tremor is sometimes seen as a side effect of medications such as amphetamines, corticosteroids, and certain psychiatric drugs, alcohol abuse or withdrawal, mercury poisoning, overactive thyroid, or liver failure. Some tremors are inherited and some occur for no known reason
The different types of tremor?
This is the most common type of tremor. It can be mild and non-progressive , but is some the tremor can progress to other body parts. Most commonly the hands are affected but it can also involve the head, trunk, legs, tongue and voice. It is typically and action tremor, occurring on movement of the affected limb i.e when reaching for a glass. Onset is typically over the age of 40 but can occur at any age. This type of tremor runs in families and children of a person with an essential tremor have a 50% chance of also developing the condition. Research has shown that there is a mild degeneration of parts of the cerebellum in people with an essential tremor.
This is associated with damage to the areas of the brain that control movement. This is usually seen as a resting tremor, occurring when the limb is at rest. It is often the first symptom of Parkinson’s disease, and can be increased with stress, emotion and exercise. This is typically seen in people over 60 yrs
Occurs in individuals of all ages affected by dystonia. It can affect any age. Dystonic tremors are irregular and often relieved by rest.
Occurs at the end of purposeful movement (intention tremor) such as when reaching t press a button. It is caused by damage to the cerebellum from stroke, tumor or disease, or from chronic alcoholism or overuse of medication.
A rhythmic muscle contraction in the legs and trunk on standing. Often perceived as beling unbalanced rather than a tremor. No other clinical symptoms are present and the tremor ceases on walking or sitting down.
This is present in everyone, however is normally not detectable to the naked eye but can be increased by strong emotion, exercise, hypoglycaemia, hyperthyroidism, stimulants, alcohol withdrawal, caffeine or fever. It is usually reversible once the cause is identified and withdrawn.
For most tremors there is no cure. Accurate diagnosis is required to establish the most appropriate treatment.
Some tremors respond to drugs therapy such as Parkinsonian, essential, dystonic, and orthostatic tremors. Enhanced physiological tremor is usually reversible once the trigger is removed.
Through improved co-ordination, control and balance a client may beable to reduce a tremor or learn to function effectively with their tremor. A physiotherapist may also be able to recommend splints and adaptive equipment to aid function.
Procedures such as thalamotomy and deep brain stimulation may reduce some tremors. These are usually only considered in severe cases and medication is mot effective.