Tremor or uncontrollable shaking is an involuntary, muscle contraction and relaxation having to and fro movements of one or more body parts: hands, arms, eyes, face, head, vocal folds, trunk and legs. Some people have tremors because of some underlying neurological disorder, while others have also felt them at some point of time, caused by fear or excitement. A common type of tremor is chattering of teeth which is caused by fear or induced by cold temperatures. This however, stops after few minutes. But uncontrollable shaking is a common symptom of disorders that destroy nerve tissues, such as Parkinson’s disease or multiple sclerosis. Uncontrollable shaking may also occur as a result of stroke or head injury. Tremors are also triggered by excessive stress or strong emotions, when a person is physically exhausted, or during certain postures or movements caused by improper functioning of the cerebellum — the part of the brain that controls muscle movements. Therefore, it becomes all the more necessary to understand the types and causes of uncontrollable shaking to be sure of what you’re dealing with.
Types Of Uncontrollable Shaking
Cerebellar Tremors or Intention Tremors
This type of tremor may occur in any external part of the body. It may happen because of some stroke which may damage the cerebella or due to excessive alcohol or withdrawal of it, and overuse of some drugs. It occurs slowly but for a broader period.
People, who are suffering from dystonia, are most likely to have this tremor. They can happen to person of any age and can be relieved by a combination of rest and some medications.
The most common of all tremors, essential tremors are progressive in some and non progressive in others. Hands are the most affected part in these tremors whereas other parts that may be affected include head, trunks, legs, voice and tongue.
These types of tremors strike a person immediately after standing and affect the legs and the trunk. And as there are no signs or symptoms present for such tremors, they are difficult to detect and treat.
Parkinsonian tremors are caused due to damage in the brain, and mostly affect people suffering from Parkinson’s disease. They start from one part of the body and spread to another part of the body and usually strike after the age of 60.
Though not visible by eye, physiologic tremors are experienced by everyone. They are heightened by strong emotions, physical exhaustion, hypoglycaemia, hyperthyroidism, stimulants, alcohol withdrawal or fever.
Psychogenic Tremors can affect any part of the body. Usually they are sudden and involve a combination of postural, action, and resting tremors. They decrease with distraction and are a result of number of psychosomatic factors.
Causes Of Uncontrollable Shaking
- Too much coffee or other caffeinated drinks
- Stress, fatigue, lack of sleep, particular vitamin deficiency, and anxiety
- Neurological disorders or conditions like multiple sclerosis, stroke, traumatic brain injury, chronic kidney disease.
- Overactive thyroid is known to cause postural tremor
- Low blood sugar
- Brain tumour
- Various drugs and prescription medicines
- Excessive alcohol consumption or alcohol withdrawal can kill certain nerve cells, leading to the condition
- Body muscles traumatized by injury, disease, or as a result of systematic illness
- Withdrawal of tobacco may also induce the problem
Diagnosis Of Uncontrollable Shaking
The cause of uncontrollable shaking can be determined by CT scan, MRI scan, blood tests and/or a bunch of other tests.
Treatment Of Uncontrollable Shaking
Depending on the cause and its severity, the future course of treatment is decided. It may include medications, some lifestyle changes, and a possible surgery if it’s too severe a problem.
Depending on the type and extent of tremors, following medications may be prescribed by the medical professional:
- Drugs prescribed for parkinsonian tremors may include any or few among the following: lovodopa, prammipexole, ropinirole, amantadine hydrochloride and anticholinergic.
- Propranolol or other beta blockers and primidone may be prescribed for treating essential tremors.
- For treatment of dystonic tremors, medical practitioner may prescribe drugs such as clonazepam, anticholinergic drugs, and intramuscular injections of botulinum toxin.
- Botulinium toxin may be prescribed for the treatment of head and other movement disorders.
- For treatment of orthostatic tremors, medicines such as clonazepam and primidone may be prescribed.
- Cerebellar tremors, however, do not respond to medical treatments.
Looking after one’s lifestyle can also decrease the severity of the problem to quite an extent. Triggers such as caffeine and other stimulants should be completely eliminated from the diet; proper amount of rest and sleep should be taken (a good 7-8 hours of sleep). In case the shaking is caused by stress, one should practice relaxation techniques like meditation, deep relaxation, or breathing exercises. To improve muscle control and strength, physical therapy may also be advised to the patient. A physical therapist will teach the patient proper exercises related to the affected area which will help in improving the condition and lessening the extent of shaking uncontrollably.
For patients whose tremors are beyond control and are not responding to drugs or exercises, doctor may suggest surgical procedures (response of few procedures is known to be excellent). Surgeries such as Thalomotomy which involves the creation of lesions in the brain region called the thalamus and Deep Brain Stimulation (DBS), which uses implantable electrodes to send high frequency electricity signals to the thalamus, are very effective in treating serious tremors.
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