Charles H. Adler, MD, PhD
Charles H. Adler, MD, PhD, Wayne and Kathryn Preisel Professor of Neuroscience Research, and professor of neurology at Mayo Clinic, Scottsdale, Arizona. MayoClinic.org
You may attribute your trembling hands to getting older or heredity…or you may fear that you have Parkinson’s disease (PD). But there are several treatable reasons for developing a tremor, including…
Medications, including cardiac medications, thyroid medicines, epilepsy drugs and psychiatric meds.
Treatable health conditions, such as hypothyroidism and hyperthyroidism. Even stress and anxiety can cause tremor.
The disorder most likely to be mistaken for PD is known as essential tremor (ET). This common condition is marked by trembling in the hands when they’re in use, known as “action tremor”—when they’re grasping objects or being used to perform an activity. Tremor also can appear in your head and/or your voice. ET slowly gets worse over years, but it is not life-threatening, and for many patients, it’s simply a minor annoyance. But ET can be disabling when it interferes with your ability to use your hands. Example: A surgeon with mild ET may find it impossible to work.
No one knows what causes ET (although 50% or more of cases are hereditary)…and there’s no cure or treatment that slows its progression. But there are treatments for its symptoms…
Medications: Most doctors treat by trial and error, prescribing a series of beta-blockers, antiseizure medications and antianxiety drugs to see which work.
Surgery: If the tremor is severe and disabling, doctors may try one of two highly effective surgeries…
Focused ultrasound: Sound waves are used to destroy the patch of brain tissue responsible for the tremor.
Deep brain stimulation: A wire is implanted in the part of the brain called the thalamus and connected to a stimulator placed in the chest. Electrical stimulation helps correct the faulty brain signals that cause tremors.
With PD, the hands shake when they are at rest, and it often is accompanied by difficulty walking, reduced voice volume, stiffness in the extremities, slow movements and reduced facial expression.
If you’re concerned about your tremor’s underlying cause, see your doctor. He/she likely will refer you to a movement-disorder specialist or a neurologist. For further information about ET, go to EssentialTremor.org. For information about PD, go to Parkinson.org or MichaelJFox.org.
