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Tremor April 1996

What is tremor?

Tremor is a rhythmic, involuntary muscular contraction characterized by oscillations (to-and-fro movements) of a part of the body. The most common of all involuntary movements, tremor can affect various body parts such as the hands, head, facial structures, vocal cords, trunk, and legs; most tremors, however, occur in the hands. Tremor often accompanies neurological disorders associated with aging. Although the disorder is not life-threatening, it can be responsible for functional disability and social embarrassment.

What are the classifications of tremor?

There are many types of tremor and several ways in which tremor is classified. The most common classification is by behavioral context or position. There are five categories of tremor within this classification: resting, postural, kinetic, task-specific, and hysterical. Resting or static tremor occurs when the muscle is at rest, for example when the hands are lying on the lap. This type of tremor is often seen in patients with Parkinson's disease. Postural tremor occurs when a patient attempts to maintain posture, such as holding the hands outstretched. Postural tremors include physiological tremor, essential tremor, tremor with basal ganglia disease (also seen in patients with Parkinson's disease), cerebellar postural tremor, tremor with peripheral neuropathy, post-traumatic tremor, and alcoholic tremor. Kinetic or intention (action) tremor occurs during purposeful movement, for example during finger-to-nose testing. Task-specific tremor appears when performing goal-oriented tasks such as handwriting, speaking, or standing. This group consists of primary writing tremor, vocal tremor, and orthostatic tremor. Hysterical tremor (also called psychogenic tremor) occurs in both older and younger patients. The key feature of this tremor is that it dramatically lessens or disappears when the patient is distracted.

Is there any treatment?

There are some treatment options available for tremor; the appropriate treatment depends on accurate diagnosis of the cause. Some tremors respond to treatment of the underlying condition, for example in some cases of hysterical tremor treating the patient's underlying mental problem may cause the tremor to disappear. Also, patients with tremor due to Parkinson's disease may be treated with Levodopa drug therapy. Symptomatic drug therapy is available for several other tremors as well. For those cases of tremor in which there is no effective drug treatment, physical measures such as teaching the patient to brace the affected limb during the tremor are sometimes useful. Surgical intervention such as thalamotomy may be useful in certain cases.

What research is being done?

NINDS investigators are currently conducting physiological studies of patients with tremors. These studies include classifying the tremor and providing appropriate therapy. The National Institute on Deafness and Other Communication Disorders also conducts research relevant to tremor.

Organizations

International Essential Tremor Foundation
7046 West 105th Street
Overland Park, KS 66212-1803
staff@essentialtremor.org
http://www.essentialtremor.org
Tel: 913-341-3880 888-387-3667
Fax: 913-341-1296

Western Essential Tremor Network
P.O. Box 284
Orinda, CA 94563
etadvocate@yahoo.com
http://www.west-net.org
Tel: 510-559-4669
Fax: 510-253-7635

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

Provided by:
The National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892