Some science behind the scenes
Tremour and its causes
The symptom of tremour can accompany quite a range of disparate illnesses. Its cause is often misdiagnosed and leads to people being mis-prescribed medication which only serves to make them ill or more ill than they were.
A practical guide to the differential diagnosis of tremor
- Alty JE, Kempster PA; Department of Neurology, Leeds General Infirmary, Leeds, UK
Tremor is, by definition, a rhythmic oscillation of a body part. It is the most prevalent movement disorder in clinical medicine, so doctors working in many specialities and in general practice can expect to encounter it. Most tremors can be classified on the basis of four observable clinical characteristics:
- anatomical pattern;
- the relative prominence of the tremor at rest, on maintaining a posture, and with action;
- tremor frequency;
- and tremor amplitude.
A resting tremor suggests Parkinson's disease, and the diagnosis then depends on a judgement about whether the patient has other signs of parkinsonism. …….There is a small but genuine diagnostic grey zone between Parkinson's disease and more benign tremor disorders such as essential tremor and dystonic tremor, in which resting and postural tremor coexist with mild or equivocal non-tremor parkinsonian signs.
In effect doctors diagnose a person with Parkinson’s disease, for example, if they have a ‘resting tremour’, but they themselves admit that there are other causes of tremour and there is a lot of room here for error.
- Other Neurological disorders - can produce tremor include multiple sclerosis, stroke, traumatic brain injury and a number of neurodegenerative diseases.
- External agents can result in tremor - the taking of drugs (such as amphetamines, caffeine, corticosteroids, SSRI), alcohol abuse or withdrawal, and heavy metals especially mercury poisoning and lead poisoning. Tremors can also be caused by some spider bites, e.g. the redback spider of Australia.
- Damage to other organs besides the brain can cause a tremor - Liver failure can cause tremor, as can an overactive thyroid. Chronic kidney disease can cause tremors. Tremors can be an indication of hypoglycemia, along with palpitations, sweating and anxiety.
- Diet - Tremor can also be caused from lack of vitamins or minerals and poor diet . Deficiencies of magnesium and thiamine have been known to cause tremor or shaking, which resolves when the deficiency is corrected
- Toxins - poisoning via toxins can cause tremor
- Stress and fatigue - lack of sleep and increased stress can result in tremors. Continual stress results in continual tremor. High levels of emotion can cause tremors
- Mutant genes - Some forms of tremor are inherited and run in families