Tremor treatment

What is tremor?

Tremor refers to rhythmic and involuntary movements that are caused by quickly alternating contraction and relaxation of muscles. Physiological tremor is present in all humans and despite being invisible it can be measured. Pathological tremors, however, can be caused by various diseases.

Different forms of tremors can be classified according to affected body region, strength, frequency and moment of situations of occurrence, which can be at rest or during movements.

What can cause a tremor?

Conditions which can cause a symptomatic tremor include Parkinson’s disese, multiple sclerosis, neuropathies and various syndromes. Tremors can also be the result of taking certain medications, toxins or injuries of nerves. If it occurs without the presence of another disease, it is referred to as essential tremor.

The first step for a doctor is to find out what causes the shaking. Patients are asked to carry out certain movements and draw patterns as well as write sentences on paper. Also blood is sampled to exclude metabolic diseases.

Tremor therapy – these options are available

Upon making the diagnosis, treatment can be started which in many cases is only symptomatic. Many diseases that are causes of tremors can bot be cured and therefore therapy can only serve to alleviate the symptoms and improve quality of life.

Physiotherapy for tremor

Physiotherapy is a basic supportive method for degenerative diseases of nerves, that aims to maintain the motivity of patients as much as possible. It will lead to no significant improvement of the tremor itself. However, patients can learn tricks that make daily movements such as writing or eating more easy.

Tremor medications

So far, no specific medications that target tremor have been developed. Anticonvulsives (for epilepsy), beta blockers (for hypertension) and minimum dose botox injections have proven of value. However, all of these medications have strong side effects and can lead to an adaptation effect.

Deep brain stimulation: Tremor surgery

Tremor is being more and more treated neurosurgically. The so-called deep brain stimulation can help those patients who do not respond adequately to medication or suffer from excessive side effects.

During this procedure, the areas of the brain that are responsible for the shaking are excited by an electrode. This has influence on the motor neurons.

At first, the neurosurgeon establishes access to the brain through a small hole. Imaging studies are carried out for the most precise placement of the electrode. The electrode is then connected to a control panel that is placed under the skin of the patients breast. Optimally, this procedure is done with local anesthesia so that the function can instantly be checked. Deep brain stimulation is a completely reversible procedure that has little complications and goes along with significant improvement of the symptoms in many cases.