Tremors, or involuntary shaking of fingers, hands, head, voice or other body parts, are inevitably startling and concerning when they first begin. Although they may be painless, it is disturbing to have something occur that cannot be controlled by an act of will. It is also frightening; although most tremors are not due to life threatening diseases, shaking can be a symptom of a more serious problem.
Causes of tremors
The first and most common cause of shaky hands or other body parts is called Essential Tremor (ET). This condition arises from messaging brain pathways that are malfunctioning. ET can begin at any age, but it occurs most frequently in older adults, possibly from slight brain deterioration that happens with aging. About half of all cases have a genetic (family history) component. While ET is considered progressive (gets worse) not all patients will experience such severe tremors that their daily function is impaired.
Tremors can also result from nine other causes:
- Brain damage from an injury or stroke
- Parkinson’s disease
- Multiple sclerosis
- Alcohol abuse or withdrawal
- Overactive thyroid
- Substances or pharmaceuticals that have an “upper” effect (caffeine, amphetamines, asthma medications, corticosteroids, certain psychiatric or neurologic medications)
- Mercury poisoning
- Liver or kidney failure
- Panic or anxiety
Since the appearance of tremors can come from any of the above 10 conditions, it is essential to obtain a correct diagnosis. Diagnosing tremors is generally done by a specialist called a neurologist. The first step is obtaining a personal and family history as well as a physical exam. Tests and imaging scans will also be ordered as needed to rule out serious diseases.
Once the cause of tremor is known, treatment is aimed at controlling the tremors if the root cause is not curable, e.g. Parkinson’s disease. If medication is not effective, or gradually becomes ineffective, tremors that result from malfunctioning brain cells or pathways may be treatable by surgically interrupting the faulty messaging center in the brain. A revolutionary treatment called MRI-guided Focused Ultrasound (MRgFUS) is a noninvasive alternative to surgical brain implants or probes. MRgFUS is a painless outpatient treatment that deadens the small area in the brain that relays abnormal messages to hands. The results are immediate and long-lasting.
Candidates for MRgFUS must be evaluated by a trained specialist. Contact the Sperling Neurosurgery Associates for more information.