Parkinson’s tremor is a common motor symptom seen in patients with the neurodegenerative disorder, Parkinson’s disease.
What is a parkinsonian tremor?
A tremor is an involuntary, uncontrollable muscle contraction, which manifests as shaking in body parts, most commonly the hands. About 70 percent of Parkinson’s disease patients experience tremors in the early stages of the disease. There are two types of tremors: Resting tremors and action tremors.
Resting tremors are the most common form of tremors associated with Parkinson’s disease. They occur when the muscles are relaxed and still, such as when the patient is lying in a bed or when their hands are resting on their lap.
In Parkinson’s disease, resting tremor often can be referred to as a “pill-rolling tremor,” due to the actions of the tremor resembling the motion of rolling a small pill between the thumb and index finger.
Action tremors are less common in Parkinson’s, but it is still predicted that more than 25 percent of patients experience them. An action tremor occurs alongside a voluntary movement and can be further classified based on the movement they accompany.
Tremors not associated with Parkinson’s disease
There are different types of tremors, of which not all are associated with Parkinson’s disease, and they vary slightly in terms of how, when and where they manifest in the body. They include essential tremor and dystonic tremor and may be associated with other conditions and genetic mutations, although a specific gene has not been identified.
A patient with a Parkinson’s tremor typically will find that their symptoms worsen and spread to other parts of the body over time. Generally, the tremor starts in one hand and can progress (normally over the course of many years) to the arm and foot on the same side of the body, and then eventually to the other side of the body. In severe cases, tremors also can affect the jaw or lips.
What treatments are there for tremors?
Parkinson’s tremors cannot be cured. However, there are several options to manage them.
Many of the typical Parkinson’s drug treatments are associated with a reduction in tremors, including levodopa and dopamine agonists. A surgical procedure called deep brain stimulation (DBS) also may be offered to control unmanageable tremors.
Physical therapy can help some patients control their tremors better, as can reducing the intake of substances such as caffeine, which can induce tremors. Many patients experience an increase in the severity of their tremors when they are stressed. Therefore, trying to reduce sources of anxiety and engaging in complementary therapies (such as yoga or aromatherapy) may help some patients.
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