Hand tremor is a movement disorder with a variety of causes. Hand tremors can be a reaction to a stressful situation or a result of fatigue after exercise. Hand tremors can also be a symptom of a disease - e.g. Parkinson's disease in older people, and multiple sclerosis or diabetes in young people. Check what other diseases may be indicated by trembling hands.

Hand tremorsare involuntary, rhythmic, alternating, or oscillating (pendulum) movements of related muscle groups in the hands. They may concern not only the hands, but also the head, facial features, torso or lower limbs.

How does tremor develop?Body movements are controlled by the interaction of the cortico-spinal (pyramidal) pathways, the basal ganglia, and the cerebellum. The basal ganglia consists of the fiery nucleus, the shell, the pale globe and the black matter, which together form the extrapyramidal system. This system is where most of the neuronal damage leading to movement disorders occurs.

Hand tremors are divided into:

  • static(postural) occurs when the patient resists the force of gravity, i.e. when he takes a certain position, e.g. when he raises or straightens his arms
  • resting- appears when the limb is supported and the patient does not have to bear the force of gravity
  • intentional- appears when the patient performs a specific, intended movement
  • complex- is a combination of the three above-mentioned types of tremors

Static hand tremor - causes

  1. Physiological tremoris the most common cause of hand tremor in he althy people. It occurs under normal circumstances, but generally causes such small movements that they only become noticeable when they are amplified by certain medications or situations, such as anxiety, stress, fatigue, use of caffeine, phosphodiesterase inhibitors or corticosteroids.
  2. Drug tremoris usually the result of long-term use of drugs and certain substances. The most common causes of tremors are amiodarone, cyclosporine, haloperidol, caffeine, cocaine, lithium, metoclopramide, nicotine, SSRIs, thioridazine, and valproate.
  3. Alcohol withdrawal- agitation and fine-wave tremors appearusually 24-72 hours after the last dose of alcohol. Sometimes it may lead to a juice blood pressure, increased heart rate, fever.
  4. Endocrine, metabolic, or toxic origin disorderssuch as:
  • anoxic, uremic or hepatic encephalopathy
  • pheochromocytoma
  • hyperparathyroidism
  • hyperthyroidism
  • heavy metal poisoning

In addition to trembling hands, there are also changes in the state of consciousness (suggesting encephalopathy) related to the detected underlying cause, exophthalmos, increased heart rate, heat intolerance (suggesting hyperthyroidism). On the other hand, sudden and uncontrolled spikes in blood pressure indicate a phaeochromocytoma.

Read also: What are the causes and symptoms of epilepsy?

Important

Spontaneous trembling of the hands, or the disease of "trembling hands"

Hand tremors may not only be a symptom of a disease, but also a separate disease. In the latter case, we are talking about essential tremor, or a disease of "trembling hands", which manifests itself in trembling, usually symmetrical, of the hands, forearms and head.Essential tremor occurs when a sick person wants to use their hands.Then they have a problem with making precise movements, e.g. writing or using cutlery. The exact causes of the disease are unknown. It is known that the incidence of this disease increases with age. Interestingly, a characteristic feature of essential tremor is the relief of symptoms under the influence of alcohol.

Resting hand tremor - causes

Parkinson's disease

Parkinson's diseaseis manifested by low-frequency alternating hand tremors, often bringing the thumb closer to the index finger (known as the rolling of the pills). These tremors appear when the hands, for example, lie comfortably on the knees or along the body. The accompanying symptoms are:

  • micrograph- a neurological disorder which consists in the gradual reduction of letters while writing, as a consequence of which the writing becomes less and less clear
  • bradykinesia , i.e. motor slowdown
  • gear-type stiffness- when performing passive movements, resistance appears in jumps
  • shuffling gait

Drug-induced Parkinsonism

Drug-induced Parkinsonismoccurs in approximately 15% of patients treated with neuroleptics. The symptoms are similar to those of Parkinson's, with the difference that there is no so-called spinning pills (fingers make involuntary movements, as if they were spinning pills,the movements of fingers and hands resemble "rolling pills")

Read also: Early Parkinson's Disease Symptoms

Intentional hand tremor - causes

Damage to the cerebellum

Cerebellum damage(Friedreich's ataxia, tumor, bleeding, abscess, multiple sclerosis, stroke)

In these cases, a low-frequency tremor, usually one-sided, occurs in conjunction with:

  • impaired body coordination (ataxia)
  • inability to inhibit movement at any time (dysmetry)
  • impaired ability to perform fast alternating movements such as turning and inverting the hand (impaired diadochokinesis)
  • speech disorder
Important

Multiple sclerosis is an insidious disease

Multiple sclerosis attacks the nervous system, so it can manifest itself differently in each person. In some people it can manifest itself as fatigue that appears unexpectedly and for no reason, in others it can manifest itself as problems with balance, trembling limbs and lack of motor coordination, and in others - problems with eyesight.

CHECK>>How to recognize the symptoms of multiple sclerosis?

Compound hand tremor - causes

Wilson's disease

Wilson's diseasemanifests itself as tremors of various types (usually in the proximal part of the arm) in children and young adults, often associated with features of liver failure, stiffness, awkward gait, smiling at inappropriate times, leakage of saliva from the mouth and neuropsychiatric symptoms.

Holmes tremor

Holmes tremoris a combination of tremor, at rest, postural, and intention tremor following damage to the midbrain (e.g., stroke or multiple sclerosis) near the red nucleus. The disease manifests itself as irregular low-frequency tremors, mainly in the head of the limbs. Sometimes signs of ataxia or muscle weakness.

Neuropathic tremor

Neuropathic tremor(in the course of diabetes mellitus, IgM neuropathy, chronic recurrent neuropathy, Guillain-Barré syndrome) is characterized by tremors of various types and frequencies.

Psychogenic tremor

Psychogenic tremoris characterized by a sudden onset, a tremor that worsens under the patient's focus and fades when distracted.

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