Types and causes of tremor

Tremor, defined as an involuntary rhythmic shaking of a body part, affects between 25% and 60% of people with multiple sclerosis (MS). MS tremor tends to affect the limbs, the head and neck, the vocal cords, and the trunk of the body. It can interfere with the ability to do everyday activities such as speaking, swallowing, writing, and walking.

It's difficult for scientists to tell exactly why people with MS experience tremor. Because MS affects so many different parts of the brain, it's hard to link the tremor to a single damaged area. However, they do know that MS tremor results from MS-related damage to areas of the brain that control movement.

People with MS may experience a variety of different kinds of tremors. The most common type of tremor in people with MS is intention tremor. Intention tremor occurs only during movement, not when a person is at rest. Intention tremor develops and gets worse as the person tries to move their body parts towards a specific target (e.g., reaching for objects, writing). It is worst during small, intricate movements, such as those needed for handwriting.

Postural tremor is a type of tremor that occurs when people are trying to support their own weight against gravity. This means it would not occur when a person is lying down, but it could happen when they are sitting or standing.

Rest tremor is not common for people with MS. This type of tremor occurs when someone is at rest. In other words, it happens when they are not moving a body part or supporting it against gravity.

Nystagmus is a type of tremor that affects the eye muscles, leading to uncontrolled eye movements.

MS tremor can range from mild to severe. When tremor is very severe, leading to large back and forth motions of the affected body part, it is called gross tremor.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Dealing-with-Tremor

Medications and surgery for tremor

MS-related tremor can be difficult to treat, but there are many different ways to manage it, including occupational and physical therapy, medications, and surgery.

A wide variety of medications have been studied for the treatment of MS tremor, including antihistamines, anti-anxiety medications, diuretics (pills that make you urinate more often), beta-blockers (medications that have a variety of effects in the body and are also used for high blood pressure), anti-spasticity medications, anti-tuberculosis, and even anti-seizure medications. Your doctor will advise you on which medication would be most appropriate for you based on your medical history and other medications you may be taking. You may need to try more than one medication before finding a medication (or combination of medications) that helps with your tremor.

Your doctor may recommend that you start a disease-modifying medication in addition to medication to help relieve your tremor. Disease-modifying medications won't directly affect your current symptoms of tremor, but they can help prevent future damage, which could help stop the tremor from getting worse.

Surgical procedures, such as thalamotomy and deep brain stimulation (DBS), have been used to treat MS tremor.

Thalamotomy uses a machine called a gamma knife to destroy nerve tissue in an area of the brain called the thalamus. Open-skull surgery is not needed. Although it may help in about two-thirds of cases, the benefits may disappear over time.

With DBS, open-skull surgery is performed to insert a small electrode in the thalamus. A wire is run to a control device in the chest area that sends electrical pulses to disrupt tremor-related nerve signals. DBS has been used for Parkinson's disease but it is still considered experimental for people with MS. For more information on surgery for tremor, speak to your doctor.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Dealing-with-Tremor

Occupational and physical therapy for tremor

There are a wide variety of treatment options for MS tremor, including occupational and physical therapy, medications, and surgery.

A physical therapist (PT) assesses problems with body movement and function, and offers ways to manage them. An occupational therapist (OT) helps make it easier for people to perform their usual daily activities. Both of these professionals can suggest ways to help manage tremor to minimize its effects on your life.

One method that may be recommended by your PT or OT is bracing, which uses a solid brace to support your affected limbs. Bracing can make it easier to do your usual activities, but it must be used with caution. In some cases, it may increase spasticity, so do not use braces unless recommended by your PT or OT.

Sometimes, applying weight to an affected limb can help minimize tremor. Your PT or OT may recommend weighted boots, ankle weights, or wrist weights. They may also recommend weighting the objects that you use, such as cutlery, canes, or walkers, to make them easier to handle. However, this may also increase fatigue, so check with your PT or OT first.

Other strategies that your PT or OT may recommend include:

  • exercises to improve balance and coordination and balance
  • exercises to "train your brain" to do certain movements with ease despite a tremor
  • adaptive devices, such as plates with lips to prevent food from spilling
  • biofeedback – using a computer to help people recognize and compensate for balance problems related to tremor
  • limb-cooling devices – some studies have shown that cooling affected limbs can provide short-term (about 30-45 minutes) relief from tremor

Your PT and OT are excellent resources for exercises, devices, and other strategies to manage life with tremor. To learn more, speak to your OT or PT.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Dealing-with-Tremor

Coping with tremor

Tremor can affect many aspects of a person's life. Not only can it make daily activities more difficult, it also can have a psychological impact. People may feel embarrassed about their tremor. They may also feel frustrated about the lack of control over their bodies. But there are ways to cope.

Get professional advice

Your doctor can advise you on your treatment options and how to use them. Your doctor may also recommend that you see other professionals, such as physical therapists and occupational therapists, who can recommend assistive devices, exercises, and other strategies to make your daily activities easier.

Master stress management

If you suffer from MS tremor, you know that it can be a source of stress. But did you know that your tremor can actually get worse in stressful situations? Those are two good reasons to learn more about stress management techniques such as deep breathing, meditation, visualization, and relaxation.

Reach for support

Don't let yourself become isolated because you feel embarrassed about people seeing your tremor. Withdrawing from the world can increase your risk of psychological conditions such as depression. Instead, find support from the places that feel right to you, whether that means a support group, friends, or family. Contact your local MS society to learn more about support options in your area, and talk to your doctor if your tremor is affecting your mood.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/MS-Dealing-with-Tremor