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Tremors are rhythmic, involuntary muscular contractions characterized by oscillations (to-and-fro movements) of a part of the body. The most common of all involuntary movements, a 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. Tremors often accompany neurological disorders associated with aging. Although the disorder is not life-threatening, it can be responsible for functional disability and social embarrassment.
There are many types of tremor and several ways in which tremors are classified. The most common classifications are by behavioral context and position. There are five such categories of tremor: - Resting. Resting or static tremor occurs when the muscle is at rest, for example when the hands are lying on the lap. This tremor usually stops during deliberate movement and is often seen in patients with Parkinson's disease. While commonly referred to as 'pill rolling' tremor of the hands, it can also affect the head, trunk, jaw and lips. It is often associated with other symptoms such as generalized slowness of motor activity, rigidity and postural instability.
- Postural. 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. Kinetic or intention (action) tremor occurs during purposeful movement, for example during finger-to-nose testing.
- Task-specific. Task-specific tremor appears when performing goal-oriented tasks such as handwriting, speaking, or standing. This group consists primarily of writing tremor, vocal tremor, and orthostatic tremor.
- Hysterical. Hysterical tremor, or 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.
Causes & Development
If shaking or trembling has been present for less than 2 years, it may be caused by temporary conditions such as:- Increased anxiety or stress
- Certain medications
- Caffeine excess or caffeine withdrawal
- Nicotine or smoking excess nicotine withdrawal
- Alcohol excess or alcohol/drug withdrawal
Such shaking or trembling could also be caused by conditions such as:- Endocrine imbalances
- Electrolyte imbalances
- Hormonal imbalances
Drugs can also cause tremor. The list includes caffeine, fluoxetine (Prozac), haloperidol (Haldol), lithium, methylphenidate (Ritalin), metoclopramide (Reglan), phenylpropanolamine, pseudoephedrine, theophylline and valproic acid.
Treatment & Prevention
Effective treatment of tremor requires distinguishing this type of movement disorder from other movement disorders. Without being seen and examined by a physician, the cause of your tremor may be difficult to determine.
Complications
If shaking or trembling has been present for two or more years and you do not have an endocrine or hormonal imbalance, you may have essential tremor or Parkinson disease.
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Signs, symptoms & indicators of Tremors:
Risk factors for Tremors:
Tremors suggests the following may be present:
Recommendations and treatments for Tremors:
KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link |  | | May do some good |
GLOSSARY
Anorexia Nervosa (Anorexia)
An eating disorder characterized by excess control - a morbid fear of obesity leads the sufferer to try and limit or reduce their weight by excessive dieting, exercising, vomiting, purging and use of diuretics. Sufferers are typically more than 15% below the average weight for their height/sex/age and typically have amenorrhea (if female) or low libido (if male). 1-2% of female teenagers are anorexic.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Electrolyte (Electrolytes)
An element or compound that, when melted or dissolved in water or other solvent, breaks up into ions and is able to carry an electric current.
Ganglion (Ganglia)
A group of nerve cell bodies clustered together in a uniform mass outside of but often close to the brain or spinal chord. Nerves run to or from the ganglia in passage to or from the brain to specific sites on the body.
Hypoglycemia
A condition characterized by an abnormally low blood glucose level. Severe hypoglycemia is rare and dangerous. It can be caused by medications such as insulin (diabetics are prone to hypoglycemia), severe physical exhaustion, and some illnesses.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Neuropathy
A group of symptoms caused by abnormalities in motor or sensory nerves. Symptoms include tingling or numbness in hands or feet followed by gradual, progressive muscular weakness.
Parkinson's Disease (Parkinson's)
A chronic, slowly-progressing disease of the nervous system characterized clinically by the combination of tremor, rigidity, extreme slowness of movement, and stooped posture. It is characterized pathologically by loss of dopamine in the substantia nigra.
Psychogenic
Of a psychological origin.
Last updated: Nov 08, 2009
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