Tremor (hands) – causes, types of hand tremors, treatment

Proven content

Hand tremors are not uncommon in both young and old people. Emotional disturbance is the most common cause of tremors in young people. Hand tremors are observed in nervous people, e.g. during an important exam or conversation. Less often, the cause lies in more serious ailments, for example metabolic disorders.

Shaking hands …

This is a condition (movement disorder) with many different causes. The tremors can be alternating, rhythmic and involuntary and affect not only the hands but also certain parts of the face, head or torso. We can meet this condition at virtually any age. Where does hand trembling come from? Well, the movement of our body is controlled by cooperating cortical-spinal tracts and the ganglia of the base of the cerebellum and the brain. The ganglia of the base of the brain consists of the pale globe, the black matter and the fiery nucleus, which together form the so-called extrapyramidal system. It is there that most neurological damage occurs, and, consequently, movement disorders.

Hand tremors are observed in many people when they are very nervous (especially in young people), e.g. during an exam or a very important conversation. The tremor is then physiological in nature. Endocrine system diseases or metabolic disorders (hyperthyroidism, liver damage, etc.) may be the cause of tremors much less frequently.

We divide hand tremors into:

— resting – appearing during rest;

— static – occurring when raising or extending the hands (assuming a certain position);

— intentional – occur when the patient wants to make the intended movement;

— complex – containing all the above-mentioned types of tremors.

Causes of hand tremors

Drinking too much alcohol is a common cause of trembling hands at all ages. Tremors can also be caused by diseases of the nervous system. For example, it is one of the main symptoms of Parkinson’s disease.

Physiological hand tremor is the most common cause of hand tremor in healthy people. Usually, these are small movements that are only noticeable when they are strengthened by fear or stress. Another cause of tremor is withdrawal from alcohol, which usually occurs 24 hours after the last dose of alcohol. Sometimes withdrawal is also accompanied by a high temperature and increased heart rate. In addition, taking some medications (over a long period of time) can make your hands tremble. Usually these are substances in the form of cyclosporine, cocaine, caffeine, nicotine as well as SSRIs and amiodarone. It should also be mentioned metabolic disorders of toxic origin, in the form of:

1. pheochromocytoma,
2. heavy metal poisoning,
3. hyperparathyroidism,
4. overactive thyroid gland
5. hepatic or uremic encephalopathy.

The aforementioned ailments, apart from hand tremors, are also accompanied by disturbances in consciousness, increased heart rate or exophthalmos.

Causes of hand tremor at rest

1. Drug-induced parkinsonism – occurs in a certain group of people treated with neuroleptics with symptoms similar to Parkinson’s disease. There is a difference, however, because parkinsonism does not have the involuntary, pill-like movements of the fingers;
2. Parkinson’s disease – when the patient experiences alternating shaking of the hands, even when the hands are resting freely on the knees. The trembling of the hands is accompanied by:
3. shuffling gait
4. micrography – characterized by a gradual decrease in letters while writing, which makes the writing very blurry with time,
5. slow motion,
6. gear-type stiffness – resistance appears when making passive movements.

Causes of intentional hand tremors

The most common cause of intentional hand tremors is damage to the cerebellum due to stroke, multiple sclerosis, the presence of a tumor or suppuration. As a result of this damage, hand tremors occur, usually one-sided, accompanied by: speech disorders, impaired motor coordination, impaired performance of fast alternating movements and the inability to interrupt a specific movement at any time.

The causes of complex hand tremor

The most common causes of complex hand tremor are:

1. psychogenic tremor – characterized by a sudden onset and a trembling of the hands that increases with the patient’s attention;

2. Holmes tremor – consisting of a tremor at rest, intention tremor and postural tremor. It occurs in the course of disseminated aneurysm or stroke. Appearing tremors are located mainly in the cephal sections of the limbs; sometimes they have features of muscle weakness;

3. neuropathic tremor – occurring in diabetics, in IgM neuropathy, recurrent and Guillain-Barre syndrome. The tremor that occurs is of various nature and frequency;

4. Wilson’s disease – is a condition in which tremors occur in children and young adults. It is often associated with stiffness, features of liver failure, and leakage of saliva from the mouth and other neuropsychiatric symptoms.

Types of hand tremors

1. Essential tremor

It occurs even before the age of 20 and very slowly increases in the following years, until it reaches a stable level. It usually begins in the upper limbs, and often also covers the head and jaw, which may affect the manner of speaking. It is less common in other parts of the body. It can occur, for example, when making a movement (then we are talking about a kinetic tremor) or holding a limb in one position (this is a positional tremor). Occasionally, essential tremor of the hands also occurs at rest (resting tremor). It then has a variable amplitude and frequency slightly higher than in Parkinson’s disease. As a rule, it is not accompanied by any other symptoms of damage to the central nervous system.

The causes of this type of tremor are still unclear. It is generally believed to be genetically determined. In its treatment, unlike in Parkinson’s disease, drugs (levodopa preparations and anticholinergics) turn out to be ineffective. The most commonly taken drug to reduce this type of tremor is propranolol. Although alcohol reduces the severity of this tremor, it is not recommended as a treatment.

2. Senile tremors

The symptoms of senile tremor are similar to essential tremors, but they do not appear until old age and are not related to the family. More often than in essential tremor, a “negative” or “nodding” head tremor occurs. Treatment with propranolol is less effective.

Hand tremor treatment

Usually, trembling hands is the result of strong emotional experiences and stress. In such people, it is recommended to use herbal preparations that not only have a calming effect, but also help to relax. If such methods do not bring any improvement, it is worth considering visiting a psychilogue who will individually select the appropriate way of coping with strong mental tension. Spontaneous hand tremor does not require a doctor’s appointment, because we are able to control it ourselves. It is enough to give up caffeine and take care of the right amount of sleep and avoid stressful situations. However, if, despite the above-mentioned activities, difficulties arise in everyday functioning – do not hesitate and see a doctor. It may be necessary to include sedative, cardiological or anti-epileptic preparations.

When Parkinson’s disease is responsible for the tremor of the hands – anticholinergics, COMT inhibitors and dopamine antagonists are used to treat low levels of dopamine in the brain. However, in the course of multiple sclerosis, the patient is given botulinum toxin, interferon and physiotherapy is implemented (these methods only slow down the progress of the disease).

Note: Hand tremor should not be underestimated as its causes can vary.

Also read: Diseases of the cerebellum

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