Types of Tremors and Their Symptoms

• Busting the myth, a study reports, tremors do not only affect the elderly but also occur in all adult age groups.
• If a tremor is left untreated, it may affect the daily routine and activities of the patient.
• According to doctors, mainly Essential Tremor is genetic. However, the study shows it is still a challenging notion. In fact, people with no family history of tremor also develop ET.

What Is a Tremor?

A tremor is an involuntarily, shaking movements in one or more parts of the body. It is most often noticeable while performing routine work like writing, holding any object or reaching for an object. Tremor may affect any body part, including the head, vocal cords, arms, torso, and legs. It may occur at different times, with breaks or continuously. Besides, it may also occur on its own or as a result of another disorder. Tremors are not life-threatening. However, they can be upsetting and even disabling, making it difficult or impossible to perform daily life tasks.

How Are Tremors Classified?

Tremors can be categorized into two main groups:

1. Resting tremor

A resting tremor happens when the muscles are in a relaxing position. For instance, hands on the chair or simply on the lap. An individual suffering from resting tremor may experience the movement of hands, arms, or legs even when they are at rest. A resting tremor, often, only affects the hand or fingers. This type of tremor is more likely to be seen in people with Parkinson’s disease. Also known as pill-rolling tremor, in this tremor, the finger and hand movements resemble rolling of pills or small objects in hand.

2. Action tremor

An action tremor occurs with the voluntary movement of a muscle. Most types of tremor are believed to be action tremor. They are further divided into several sub-categories. For instance:

• Kinetic tremor is usually associated with any controlled body movement, such as closing and opening the eyes or moving the wrists up and down.
• Postural tremor refers to a tremor when an individual tries to maintain a position against gravity, such as stretching the arms.
• Intention tremor occurs when there's a purposeful movement toward a target — for example, trying to pick up the spoon or lifting a finger to touch the nose.
• Isometric tremor occurs when a muscle becomes tense against a rigid stationary object.
• task-specific tremor only occurs when performing highly-skilled, goal-oriented tasks such as handwriting or speaking.

What Are the Different Types of Tremors?

Even though tremors are not acute, they are upsetting and impeding when it comes to daily tasks. And as there are so many different types of tremors, it is difficult to distinguish one from another. We have listed the eight most common types of tremors and their symptoms.

Essential Tremor

Essential tremor most commonly affects the arms and hands during activities. It is often noticeable while performing tasks such as drinking from a cup, writing or reaching for an object. In several cases, both sides of the body are more or less equally involved. The essential tremor, also known as shaky hands, affects the head, causing shaking of the head in a side-to-side or up-and-down manner. This condition may also cause changes in the volume and smoothness of speech. Essential tremor effects usually remain mild and stable for quite some time but can slowly worsen over time. Symptoms:

• Fast, shaking movements of the hands and arms, usually during movement.
• Head nodding (usually in a “yes-yes-yes” or “no-no-no” movement)
• Quivering of the voice
• Balance problems

Parkinsonian Tremor

Often, the first sign of Parkinson’s disease, Parkinsonian Tremor is a type of resting tremor. It is most common in older people, particularly above the age of 60. Parkinsonian Tremor occurs when parts of the brain that control the movements stop working. In fact, this type of tremor can cause harmful effect on drug users, those with infections, and those with other neurodegenerative disorders. The tremor makes the hands move uncontrollably in a motion referred to as pill-rolling. Like other tremors, Parkinsonian tremor is often instigated by stress. Symptoms:

• Stiff muscles
• Slow movements
• Head shaking
• Memory problems
• Trouble peeing or pooping
• Tiredness
• Drooling
• Fear and anxiety
• Confusion
• Dementia, or difficulty with thinking and reasoning
• Loss of smell

Physiologic Tremor

Physiologic Tremor is provoked by too much stress, caffeine, low blood sugar, or alcohol withdrawal even though it's hardly noticeable. The natural frequency of this type of tumour is about ten times per second. It affects the hands temporarily—mainly when the fingers are fully stretched. However, it disappears when the underlying cause (i.e., eating or distress) is eliminated. Symptoms:

• Trembling in the hands, arms, head, legs, or torso
• A shaky voice
• Difficulty while writing or drawing
• Difficulty while holding and controlling utensils, such as a spoon.

Dystonic Tremor

Dystonia tremor is a movement disorder in which an individual experiences muscles spasm uncontrollably. The contraction or spasm causes the concerned body part to twist reluctantly, resulting in abnormal postures. The dystonic tremor can make managing everyday activities difficult and cause fatigue to the patient. As with all types of tremors, a dystonic tremor also worsens with stress or anxiety. Symptoms:

• A dragging leg
• Uncontrollable blinking
• Cramping of the foot
• Involuntary pulling of the neck
• Speech difficulties

Psychogenic Tremor

Psychogenic tremor is exacerbated voluntarily or subconsciously by a patient. It might show characteristics of resting as well as action tremors. That is why; this tremor is difficult to differentiate from other forms of tremor. A psychogenic tremor starts suddenly and may affect all parts of the body in the long run. Symptoms:

• Shaking of hands, torso, legs, head or arms
• Onset in stressful situations
• A shaky voice and nodding head
• Unexplained muscle contractions

Orthostatic Tremor

Orthostatic tremor is typically identifiable with instability on standing still, which improves while walking. In this type of tremor, a patient may or may not be aware of quivering legs. Besides, the tremor and postural unsteadiness tend to worsen with a prolonged stance. The orthostatic tremor has such high frequency that it may not be visible to the naked eye but can be diagnosed by touching the thighs or calves or by listening to these muscles with a stethoscope. The orthostatic tremor is position-specific (mainly, standing) and disappears when an affected individual sits, walks or lies down. Symptoms:

• Leg pain
• Stiffness in legs
• Shaky legs
• Imbalance while standing
• Weakness in legs

Cerebellar Tremor

A cerebellar tremor is caused due to the damaged cerebellum pathways. It most usually occurs with intention tremor, which means; it affects the controlling movement and balance of the body. For instance, grasping an object, pushing a button, and keeping the hand steady. The cerebellar tremor worsens when a hand or finger is about to reach the target (i.e., another hand, object, or button). Symptoms:

• Speech disorder
• Rapid involuntary eye movement
• Abnormality in walking
• To-and-fro movements of the neck

Rubral Tremor

Rubral tremor is severely slow and impactful as it affects all parts of the body. In a rubral tremor, the body experiences sudden and uncontrolled muscle contractions. As a result, the entire body becomes rigid further resulting in abnormal postured. Fortunately, it is one of the rare types of tremors. Rubral tremor commonly occurs following a stroke, and therefore, no simple treatment, therapy, or medication can ease or prevent it. Symptoms:

• Uncontrollable shaking
• Onset in stressful situations
• Tiredness
• Fear and anxiety

If an individual comes across any of the above types of tremors, they should immediately consult a doctor. The early it is diagnosed; the more effective will be the treatment.