Diagnosing and Treating Tremors

Diagnosing Tremors

Tremor is diagnosed during a thorough neurological and physical exam. However, the cause of the tremor may not be diagnosed until further tests are performed. These may include:

• family history
• blood and urine tests to check for signs of thyroid disease or other disorders
• electromyogram to measure involuntary muscle activity and muscle response to nerve stimulation

Treating Tremors

The appropriate treatment for tremor depends on an accurate diagnosis of the cause. If the tremor is caused by a medical condition or by a side effect of medication, then treating the underlying cause may eliminate it. However, medications may also be prescribed, especially if an underlying cause is not evident.

• Beta blockers – normally prescribed to treat high blood pressure, but have been shown to reduce tremors in some people.
• Anti-seizure medications – frequently used, especially in people who cannot take beta - blockers or who are not helped by beta-blockers.
• Botulinum toxin (Botox) injections – useful in tremors that affect the face, head or voice.

Physical therapy may help strengthen muscles and improve coordination. Tremors may be helped by the use of light wrist weights and adaptive equipment such as heavier utensils.

Brain stimulation surgery may be an option for those with certain tremors. During this operation the  surgeon inserts an electrode into the area of the brain responsible for the tremors. Once the electrode is in place, a connection to a small stimulator device, typically located in the upper chest area, is made by  a wire which is implanted under the skin. The stimulator sends mild electrical pulses to the electrode, which stops the brain from producing tremors.