Dr. Joon Faii Ong has dedicated his life to the study and treatment of tremor disorders. He has helped patients live happy and thriving lives despite the challenges of a condition that is often misunderstood.
In the following article, Dr. Ong discusses current treatments for tremor disorders. He also provides information about possible advances in treatment for this group of conditions in the future.
What Are Tremor Disorders?
Tremor is a common movement disorder, affecting 5% of the population.
In many cases, tremors are not life-threatening and do not require treatment. However, tremor disorders can interfere with daily activities and make it difficult to perform jobs or even basic tasks like eating.
Tremors may be caused by conditions such as Parkinson’s disease, strokes, or essential tremors. However, most people with tremors do not have an identifiable cause. Instead, they are diagnosed with primary (idiopathic) tremor—which occurs when there is no abnormal function anywhere in the body.
There are several types of tremor disorders, including resting tremor (tremors that appear when at rest), postural tremor (tremor appearing during voluntary movement), and action or kinetic tremor (tremors that begin once the body has finished initiating movement).
What Causes Tremor Disorders?
Irregularities in brain cells cause primary (idiopathic) tremors. These irregularities cause the muscles to shake or tremble, sometimes severely. The brain cells responsible for controlling movement are located in the cerebellum and deep within the brainstem—two areas that scientists have been unable to image directly, making it difficult to determine exactly what causes tremor disorders.
Factors That May Increase Risk of Tremor Disorders
There is a higher risk of tremor disorders in people with a family history of these conditions. Tremors are also more common among older people.
What Are the Current Treatment Options?
Currently, there is no cure for primary (idiopathic) tremor. However, treatment options often reduce the intensity and frequency of tremors—allowing patients to live their lives with less impact from these conditions.
Some patients may opt to reduce stress in their lives—which can help reduce the severity of tremors. Other treatments include medications that control tremors, deep brain stimulation, and dietary modifications.
Medication for Tremor Disorders
There are a variety of drugs used to treat tremor disorders, many of which are designed to correct the brain’s misfiring signals that cause tremors.
The most common medications used to treat tremor disorders include:
– propranolol (Inderal LA, Innopran XL)
– primidone (Mysoline)
– gabapentin (Neurontin)
– clonazepam (Klonopin)
– levodopa-carbidopa (Sinemet, Parcopa, Atamet)
– benztropine mesylate (Cogentin)
Deep Brain Stimulation for Tremor Disorders
Deep brain stimulation is a surgical procedure that may treat patients with severe tremors that do not respond to drug treatment.
During this procedure, a device is implanted into the brain and can help control tremors by delivering electric signals to affected areas of the brain. This treatment helps reduce tremors in up to 80% of patients who are good candidates for surgery. However, it is associated with several possible risks, including infections, bleeding, pain, and the possibility of problems with speech or memory.
Dietary Changes for Tremor Disorders
A change in diet is an option to reduce tremors. Research indicates that a few dietary changes can help balance brain chemistry and alleviate tremor symptoms:
Avoid caffeine: Caffeine causes the body to produce extra hormones that make the brain more excitable. This increases the risk of having tremors caused by an overactive nervous system which can make symptoms worse. Additionally, caffeine-containing beverages like coffee and soda contain phosphorus—which is especially dangerous for people with tremor disorders because it worsens neurological conditions already occurring in the body.
Avoid nicotine, alcohol, and other drugs – The chemicals in nicotine and alcohol can worsen tremors. Marijuana and other recreational drugs can also increase the risk of tremor disorders by exacerbating neurological conditions that cause tremors.
Eat a diet rich in vegetables, fruits, and whole grains – A well-balanced diet helps maintain healthy levels of vitamins, nutrients, and minerals.