»   Who Is Affected By Tremor ?

  »   Tremor In Other Conditions

  »   Managing Tremor

The typical Parkinson's Disease tremor occurs mostly at rest ("resting tremor") and lessens during sleep and when the body part is actively in use. For example, your hand might shake while you're sitting, or even while you are walking, but when you reach out to shake hands with someone, the tremor is less noticeable or goes away entirely.

Tremor tends to occur in the hands and is often described as "pill-rolling"; imagine you are holding a pill between your thumb and forefinger and continously rolling it around. But it can also appear in other parts of the body, including the lower lip, jaw or leg. These tremors can interfere with routine activities such as shaving, dressing, writing and many other task that require fine motor coordination.

Some people report an internal tremor, a shaking sensation inside the chest, abdomen or limbs that cannot be seen.

Tremor usually affects only one side of the body, especially during early stages of the disease. With disease progression, both sides may become affected. Fatigue, stress or intense emotions can temporarily make tremors worse.

Who Is Affected By Tremor?

About 70% of people with Parkinson's experience a trmor at some point in the disease. Tremor appears to be slightly less common in younger people with Parkinson's Disease, though it is still one of the most troublesome symptoms. People with resting tremor usually have a more slowly progressing course of illness than people without tremor.

Tremor In Other Conditions

While tremor is a common symptoms of Parkinson's, it can also be a symptoms of other conditions, most notably essential tremor. The main different between a Parkinson's Tremor and most other types of tremors is that in Parkinson's Disease, a resting tremor is most common. Other conditions are usually characterized by "action tremor", which tends to lessen at rest and increast when you're doing something, like trying to make a phone call or take a drink. Tremors of the head and voice are also common in essential tremor but rare in Parkinson's Disease.

Managing Tremor

Levodopa is the medication most commonly given to control the movement symptoms of Parkinson's, and tremor usually, though not always, responds to levodopa treatment.

If dopaminergic medications do not work to control tremor, other medications are sometimes used. For example, anticholinergics can be helpful for tremor. However, they can cause significant mental and physical side effects, so their use should be carefully considered. Anticholinergics are most useful in young people with tremor-predominant Parkinson's, when tremor is the main symptom that needs managing.

If medications are not effectve, deep brain stimulation (DBS) is generally successful in controlling tremor, even medication-unresponsive tremor. In addition to medication and surgical treatment, there are assistive devices that can help with various activities of daily living. Last but not least, exercise is as important as medication and other therapies for managing Parkinson's symptoms and leading your best possible life.

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