Tremors are a symptom of several conditions, and are quite common. We want to talk about them because they are a warning sign that observers notice before the person who experiences them and you can help your friends and family with early detection.
There are many kinds of tremors and they each indicate different things and need to be treated differently from a medical or health standpoint.
If you notice a tremor in someone (or even yourself) there are things you need to know to help differentiate one type from another. It is important to determine whether a tremor is from a disease that can be treated or if it is benign and your treatment is based on relieving symptoms.
Before going to your doctor with a tremor, you should be aware of the important signs that are significant to diagnosis and treatment. For example, if you have a tremor you should know if you have it when you are at rest (not standing or doing something) or if you have it when you are trying to do something or standing (resisting gravity). Most tremors are action tremors but the most common kind of tremor (essential) is usually a resting tremor (e.g. if your hand rests on your knee and you are not using it for anything, it trembles or shakes).
The next sign related to tremor (after resting or action) is a review of medications, substances, and foods that can cause a tremor (eg. caffeine, low blood sugar, hyperthyroidism or too much thyroid medicine, ADHD meds, illegal substances cocaine or methamphetamines)
If all of the above are ruled out, then the next most common cause of tremor that should concern you are those from Parkinson’s disease. Your doctor will ask if you lose your balance, or if you move more slowly and insecurely than usual, or if you have lost facial expression. Most Parkinson’s symptoms are unilateral (one side of the body) not bilateral (both sides of the body). If these signs are present, physicians will document with an MRI and begin treatment with Parkinson’s medications.
If you don’t have Parkinson’s but most probably have an essential tremor (usually resting), then your physician will have to rule out dangerous conditions like brain tumors, stroke or degenerative brain disease like dementia. When these are proven not to be the problem then the only diagnosis left is essential tremor. A test you can do at home to see if you have an essential tremor is to drink two glasses (or drinks) of alcohol and if the tremor stops, it is an essential tremor.
Essential tremors are genetically inherited and affect up to six percent of the general population. This type of tremor is treated effectively with a beta -blocker like metaprolol or propranolol, or seizure medication like primidone. Essential tremors usually get worse with age, so medications need to be changed as they get worse and you get older. Essential tremors are among the safest and most common tremors to have. They do not evolve into worse conditions, the tremors just become more difficult to treat.
If you have a tremor you must get it evaluated so that you do not waste time and energy on worry. Because a tremor can be a sign of progressive diseases, ignoring a situation that can benefit from treatment,(e.g. deterioration of Parkinson’s, growth of brain tumors, dementia that is progressive, etc.) Early diagnosis and intervention for these types of tremors is a very important and beneficial intervention. It will improve your quality of life and maintain your sense of self as you age.
