Trembling can be caused by neurological problems, stress, medications or psychological disorders. It can interfere with normal function and careful evaluation is needed to determine the cause and best course of action. Myoclonus can be mistaken for tremor and accurate diagnosis is important for appropriate treatment.
Trembling is shaking, commonly caused by neurological problems, stress, or medications. Some patients may experience isolated and intermittent tremors, while others may develop tremors throughout the body. Careful evaluation is needed to find out why the patient is shaking and to determine the best course of action to manage the problem. It is usually a symptom of an underlying medical problem, and checking for the cause can resolve or reduce the agitation.
Some patients experience trembling in response to trying to complete a specific task, such as walking, while others tremble randomly. Shaking can make walking, eating, or talking difficult because it interferes with normal function. The elderly tend to be more prone, although it can also occur in young patients.
One reason for developing tremor is a neurological problem that can be caused by disease or injury; brain damage and Parkinson’s disease, for example, can both cause tremors. Brain injuries can be difficult to treat, but medications can help control the shaking. Patients may also consider physical therapy to help them regain muscle control and learn to perform tasks even when they are shivering. Speech therapists can help people learn to eat and talk despite tremors.
Stress, anxiety, and some psychological disorders can also cause tremors, as can trauma. Someone who has just been in a serious car accident, for example, may shake uncontrollably with fear, relief, and other emotions. PTSD may be associated with tremors in some patients, who may experience tremors in connection with flashbacks. People who suffer from panic attacks can also experience this symptom.
The medications have also been known to cause shaking and trembling and can be singled out as the culprit in a patient interview to find out more about when and how the symptom first developed. The agitation may resolve if the drug is stopped, or it may persist, sometimes for life, in the case of some psychiatric drugs. This is a known risk of some antipsychotics, for example, and an important consideration in prescribing practices.
Sometimes myoclonus, involuntary muscle contractions, is mistaken for tremor. In these patients, random muscle jerking can create the appearance of shivering or shaking. Tests can show that the problem is caused by a muscle misfire, not neurological problems or reactions to psychological stress. Accurate diagnosis with brain imaging and muscle testing is important, because it can impact the most appropriate treatment for the patient; someone with myoclonus, for example, doesn’t need medications used to treat tremors related to Parkinson’s.
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