Tremors - Symptoms, causes and treatment

Tremors are uncontrollable shaking movements that occur repeatedly, without realizing, and it happens in one or more parts of the body. Tremor most frequently seen and happens at hand. However, movement This shaking can also occur in other parts of the body, such as the legs or head.

Tremors occur due to disturbances in the part of the brain that functions to regulate muscle movement. Tremors may be experienced intermittently or continuously. This condition can also appear as a symptom of other diseases. Therefore, the appearance of repeated tremors should not be underestimated.

Causes of Tremor

Tremors are caused by a disturbance in the part of the brain responsible for regulating muscle movement. The disturbance and damage causes uncontrolled muscle contractions that cause tremors or shaking.

Tremors are generally a symptom of a disease that affects the central nervous system and movement. Some diseases that can cause tremors are:

  • Multiple sclerosis
  • Hyperthyroidism
  • Parkinson's disease
  • Head injury
  • stroke

In addition to the diseases mentioned above, several conditions can also trigger tremors, including:

  • Low blood sugar levels (hypoglycemia)
  • Muscle fatigue
  • Mercury poisoning
  • Consumption of caffeine, such as that found in coffee, tea, or soda
  • Anxiety or panic disorder
  • Side effects of using drugs, such as asthma drugs, amphetamines, corticosteroids, lithium, and some antidepressants
  • Liver failure or kidney failure
  • old age
  • Family history of tremors

Types of tremors

As previously mentioned, tremors can be caused by certain diseases, or triggered by certain conditions. Here is the division of tremors based on the cause:

1. Essential tremor

Essential tremor is the most common type of tremor. The exact cause of this tremor is not known, but generally tremors are related to heredity. A person with a parent who suffers from essential tremor is more at risk of developing the same condition.

2. Psychogenic tremor

Psychogenic tremors are caused by mental disorders, such as depression and post-traumatic stress disorder (PTSD). These tremors can occur in any part of the body suddenly. Tremors will usually look more severe when the sufferer is under stress and improve after the stress subsides.

3. Cerebellar tremor

These tremors are caused by damage to the cerebellum (cerebellum). This condition can occur as a result of stroke, tumor, or cancer multiple sclerosis.

4. Parkinson's Tremor

These tremors appear as part of the symptoms of Parkinson's disease. This condition is generally experienced by people aged over 60 years. Tremors in Parkinson's disease generally have a type resting tremor, i.e. appears at rest.

5. Dystonic tremor

Dystonic tremor occurs in people who experience dystonia. These tremors can occur in any part of the body and are characterized by rotating and repetitive motion of the body part. This condition will usually subside after rest.

6. Orthostatic tremor

The exact cause of orthostatic tremor is not known. This tremor is characterized by contractions in the leg muscles that occur shortly after standing and will subside when a person begins to lift the leg, walk, or sit.

7. Physiological tremor

Physiological tremor is generally caused by a disease outside the nervous system, such as thyrotoxicosis or hypoglycemia. This type of tremor will subside on its own once the cause is addressed.

Symptoms of Tremor

Tremor is characterized by several symptoms, namely:

  • The appearance of uncontrollable shaking movements of the hands, arms, legs, and head
  • The appearance of a vibrating voice when speaking
  • Difficulty writing or drawing due to shaking
  • Difficulty grasping or using eating utensils due to shaking

Based on the time of occurrence of symptoms, tremors are divided into two types, namely:

  • Rest tremor

    This tremor occurs at rest, for example when sitting with arms folded or standing with arms hanging. These tremors generally occur in the hands and fingers.

  • Action tremors

    This tremor occurs during movement, such as when writing, stretching out an arm, lifting a heavy object, or when a finger is pointing at an object.

When to go to the doctor

Immediately consult a doctor if the appearance of tremors gets worse, interferes with activities, or is accompanied by the following symptoms:

  • Happened suddenly
  • Occurs at the age under the age of 50 years and there are no hereditary factors
  • Accompanied by changes in gait, muscle weakness, difficulty speaking, and heart palpitations

Tremor Diagnosis

To diagnose tremor, the doctor will ask questions about the complaints or symptoms experienced, history of drug use, and the patient's and family's medical history.

After that, the doctor will also perform a physical examination to determine:

  • When the tremor occurs, does it occur while resting or moving?
  • The part and side of the body that has tremors

During the examination, the doctor will ask the patient to write, hold an object, touch the nose with a finger, draw a spiral, and so on. In addition, the doctor will also perform a neurological examination to detect any disturbances in the nervous system.

To confirm the diagnosis, the doctor will perform several supporting examinations, such as:

  • Blood tests, to detect thyroid hormone function and levels of certain substances that can cause tremors
  • Scans with CT Scan or MRI, to see abnormalities in the brain
  • EMG (electromyogram), to measure muscle activity and see the response of muscles to nerve stimulation

Tremor Treatment

There is no specific treatment for tremors. In some cases, treatment may not be necessary if the tremor is mild or not due to a specific disease or condition.

Treatment is usually done by treating the condition that is causing the tremor. For example, if the tremor is caused by hyperthyroidism, treatment is carried out by treating the hyperthyroidism.

Several treatment methods can be used to treat tremors, including:

  • Drugs

    Several types of drugs are used to treat tremors, namely: beta blockers (drugs that dilate blood vessels), sedative, or anticonvulsant drugs.

  • Botox injections

    The doctor will inject botulinum toxin (Botox) into the muscles of patients experiencing tremors. This injection will reduce the intensity of tremors that often occur.

  • Physiotherapy

    Physiotherapy aims to help patients to control tremors and adapt to the tremors they suffer, so they can still move. In addition, physiotherapy also aims to train and improve the patient's body coordination ability.

  • brain surgery

    If the tremor is very severe, interferes with activities, and does not subside in the ways mentioned above, your doctor may suggest surgery thalamotomy (removal of the part of the brain suspected of triggering the tremor), so that the tremor can stop.

In addition, DBS implants can be installed (deep brain stimulation), to control impulses in the brain, and is expected to reduce tremors, especially essential tremor.

Tremor Complications

Tremors are generally not a serious condition. However, if it is caused by Parkinson's disease, the condition can get worse as the disease progresses.

If it occurs frequently and increases in intensity, tremors can also cause complications such as:

  • Difficulty performing daily activities, such as eating, bathing, and working
  • Social disorders due to sufferers limiting physical activity, travel, and communication with others to avoid embarrassment due to tremors

Tremor Prevention

There are no really effective preventive measures to prevent tremors. The best thing that can be done is to follow the treatment recommendations given by the doctor if you have a disease that causes tremors. In addition, limit and avoid things that can trigger tremors, such as:

  • Limit or avoid caffeine consumption if doing so can cause tremors
  • Stop smoking
  • Stop excessive alcohol consumption