What is Tremor?

Tremor is an involuntary shaking movement that is repeated over and over. Tremor most commonly affects the hands and head. Sometimes, the feet, legs, or torso may shake. Some people have a “tremor” of their voice- this is called spastic dysphonia. When I see a patient with tremor, I look for a few important characteristics:
1) Does the tremor occur at rest (without any movement of the affected body part) or does it occur with movement?
2) Is the tremor focal (affecting only one body part) or is it bilateral (affecting both sides of the body)?
3) In addition to the tremor, are there other associated symptoms or signs such as difficulty walking, falls, stiffness of the body, slowness to movement, or difficulty with vision, speech, or swallowing?
Essential tremor, which sometimes runs in families, is one of the most common types of tremor. This type of tremor can affect the arms, head, or voice. The tremor worsens with movement such as lifting a cup or pointing to an object. The tremor usually abates at rest. Katherine Hepburn had this type of tremor and in her case it affected her voice, head, and arms. However, this type of tremor can affect just one body part. Safe and effective medicine can significantly help this disease.
Common medicines used to treat this condition are Primidone (a drug in the anti-seizure class), Propranolol (a beta blocker), and Clonazepam (a benzodiazepine). Even surgery can be performed which can help.
Deep brain stimulation is a surgical procedure performed in both Essential tremor and Parkinson’s disease. A pacemaker device is inserted into the chest and a wire is threaded up and inserted into the brain. Mild electrical currents are sent to the deep structures of the brain, which controls the tremor.
Other causes of tremor can be systemic illness such as kidney or liver failure. Medications such as lithium, anti-psychotic drugs, Depakote, SSRI’s (antidepressants), steroids, and inhalers used in lung disease such as asthma also cause tremor. Smoking and chronic lung disease also can cause tremor. Parkinson’s disease is a cause of resting tremor and can be associated with falls, gait dysfunction, slowness to movement, and swallowing difficulty. We will discuss Parkinson’s disease at another time and leave that for another article.
If you would like to learn how to care for this disease or any other neurological condition, please call at 609-463-8009 or 609-653-9595. My office is conveniently located at 4 Village Drive in Cape May Court House and 160 Shore Road in Somers Point. Please visit my website at www.stzorfas.com
-Submitted by Dr. Scott Tzorfas