We often see people with tremor, but get confused about the specificity of that tremor. Most of us don’t know whether it’s a common problem or it’s linked to a specific disease. Here, we discussed the 5 most commonly known types of tremor. This will help you to understand the nature of tremor when you see someone with trembling hands.
Tremor is a rapid back-and-forth movement of one or more body parts. It primarily affects the hands but can also appear in other parts like arms, legs, neck, and head. In addition, people with tremor can also have a shaky voice.
There are many forms of tremor. Some appear without any cause, others are linked to brain diseases. Following are the 5 most commonly known forms of tremor.
1. Physiological Tremor
This type of tremor is not related to any neurological conditions and can occur in healthy individuals. It mostly affects the fingers, hands, and forearms.
It is usually very weak and cannot easily be seen with eyes. But it becomes noticeable when a person is anxious or stressed out. It can also be more pronounced when someone consumes caffeine or takes certain medications.
People with low blood sugar or facing alcohol withdrawal conditions can also develop this type of tremor. It usually doesn’t require any treatment and diminishes when the cause of the tremor is removed.
2. Resting Tremor
Resting tremor occurs in people who are suffering from Parkinson’s disease. Parkinson’s is a progressive brain disorder that develops when the brain lost a certain group of cells that produce dopamine, which is a neurotransmitter responsible for controlled body movement. Additional symptoms of the disease include slowness of movement, rigidity, and balance issues.
As the majority of Parkinson’s patients have resting tremor, it’s often used as a positive diagnostic criterion for Parkinson’s disease.
Resting tremor usually affects the hands or arms. The tremor appears when the hands are at rest; that’s the reason why it’s called resting tremor. Most often, it looks like a person is trying to roll a pill between the thumb and index fingers.
Besides hands, the resting tremor can also affect the legs, chin, face, and lips. Some patients may also show tremors in head and voice; however, these are rarely reported. The tremor starts on one side of the body. But as the disease progresses, it spreads to the rest of the body. It becomes worse when a patient is under stress or experienced strong emotions.
The exact cause of resting tremor is unknown. Only 10% of the cases are reported to have a family history. It is more common in men than in women.
Resting tremor is often treated with anticholinergic drugs like benztropine and trihexyphenidyl. The other commonly used drug is levodopa, which is prescribed when symptoms like the slowness of movement and rigidity are also present.
3. Action Tremor
This type of tremor appears in people affected by essential tremor, which is one of the most commonly known motor disorders.
Action tremor is extremely popular. It is estimated that approx 1% of the world population is affected by this condition. In this tremor, hands are primarily affected. It appears when the hands perform different activities; such as eating, drinking, or writing. Other parts, like the head and sometimes voice, may also be affected by this tremor. It usually starts on both sides of the body.
Action tremor progresses over time and its intensity can vary. Sometimes, it is mild; other times, it is fast. It can get worse if a person consumes caffeine or when the sugar level in the blood happens to be lower than normal.
Although essential tremor is a typical motor disorder, it’s now increasingly realized that this disorder also has some non-motor features. The most common non-motor symptoms include cognitive deficits, hearing loss, and personality changes. In addition, people with essential tremor may also experience sleep problems.
Genetics play a big role in the development of essential tremor. About 50-70% of patients have a family history. Although the disease can appear at any age, people with 40 or above are more affected. It tends to affect both men and women equally.
The most common drugs used to treat action tremor include primidone and propranolol. Primidone is a beta-blocker that is used as first-line therapy. Propranolol is an anti-epileptic drug and is prescribed when the tremor is not responding to primidone.
4. Cerebellar Tremor
It is also called intention tremor. But since it’s caused by damage to the cerebellum part of the brain; hence more commonly known as cerebellar tremor. The cerebellum is the back part of the brain that is mainly involved in movement coordination and balance.
The damage to the cerebellum results from a brain disease called multiple sclerosis, which is a neurological condition that disrupts communication between the brain and the rest of the body. Tremor is often considered the early symptom in multiple sclerosis. In addition to tremor, a patient experiences problems with leg movement, vision, balance, and sensation.
Cerebellar tremor can also be caused by a stroke or when there is a tumor in the brain. Extremities and mostly the upper limb (like arm and leg) are mainly affected by the cerebellar tremor. The intensity of the tremor is usually slow and can easily be seen with eyes.
Cerebellar tremor is a nasty one and is often difficult to manage with a specific type of medication. Most often a patient can undergo several drug trials to find the most effective one. Sometimes the drugs used for action tremors can also be effective for cerebellar tremor.
5. Dystonic Tremor
This type of tremor occurs in people suffering from dystonia, which is a movement disorder characterized by involuntary muscle contractions. People with dystonia show twisting, repetitive movement, and postural abnormalities of the limbs, face, trunk or other parts of the body.
Tremor is a key symptom in dystonia. It can affect a specific part of the body (like hand, arms, and neck) or the entire body. Dystonic tremor appears when the affected parts are in action, and diminishes when they are at rest. It gets worse when a person experiences stress or anxiety.
Drugs like trihexyphenidyl, clonazepam, and botulinum injection are used for treating dystonic tremor. Levodopa, which is used to treat Parkinson’s symptoms, may also be effective in relieving the tremor.