Tremor in Parkinson’s Disease

Tremor is one of the most common and persistent symptoms of Parkinson’s disease (PD).  Since the disease mainly affects the motor system of an individual, the patient experience shaking and is unable to control movement normally. Characterized as rhythmic, muscle contraction involving oscillations or twitching movements of one or more body parts, tremors can affect the PD fighter’s hands, arms, eyes, face, head, vocal folds, trunk and legs. Almost 25% of people who develop PD experience trembling or shaking in one of the hands.

In the early stage, an individual experiences a slight tremor in the hand or foot, on one side of the body. However, the most common onset is the tremor in one finger. Usually, a shaking movement appears when the patient’s muscles are at rest or relaxed. As the disease progresses, the patient experiences intense trembling when the fingers or hands are folded in the lap, or when the limb is relaxed. Such tremors can potentially cease the patient whenever he tries to perform an action. Though it is the most visible sign of the disease, in few cases, people with PD do not observe tremors. Some individuals are able to control a hand tremor by upholding a flexed grip.

While the exact cause of tremors in PD is not known, it is commonly believed that it is caused by a loss of dopamine in the areas of the brain that support movements. Tremors in PD are often supplemented and enhanced by muscle rigidity, postural instability, sleeping disorder, dizziness or fainting , depression and anxiety.

Options to treat Tremor in Parkinson’s Disease

Even though Tremors in Parkinson’s cannot be cured completely, certain medication, surgery and therapeutic methods can help ease and reduce them in some patients. As different people experience different levels of tremor severity, one treatment method does not fit in all patients’ disease management plan.

Medication

There are a number of medications classes that can be prescribed for easing tremors. These medications focus on increasing or substituting for dopamine in the brain. Anticholinergics are more helpful for treating tremor-predominant younger patients. Other commonly prescribed medications include Carbidopa-Levodopa, COMT Inhibitors, MAO-B Inhibitors and Amantadine. Foot swelling and hallucinations are among most common side effects.

Surgery

Surgery is mainly used to treat people whose tremors cannot be controlled by medication. Surgical option can help patients to ease the symptom, but cannot completely cure the condition. Currently, the most used surgical treatment for PD led tremors is Deep Brain Stimulation (DBS). In this method, electrodes are inserted into a targeted area of the patient’s brain to relieve him from tremors.  The benefits of this surgery last for five years.

Other less popular surgical methods for treating tremors (recommended for PD patients who have exhausted medical treatment) include Thalamotomy, Pallidotomy and Subthalamotomy.

Alternative Methods

As per a study, stationary cycling exercise results in reduced tremors. Since tremors can be aggravated due to stress, Guided Imagery has also been beneficial for some patients.

Yoga is also emerging as a popular complementary therapy for treating PD led tremors. A study by American Parkinson Disease Association (ADPA) confirms that PD fighters who start practicing Yoga reduce tremors.