Parkinson’s and Tremors
Tremors are repeated uncontrollable, rhythmic movements in one or more parts of the body. They are the most widely known symptom of Parkinson’s disease and often only affect one side of the body. The type of tremors is an important part of the diagnosis.
The tremors most common in Parkinson’s disease are resting tremors.
- They occur when the limb is inactive, for example, when the person is sitting with their hand on their thigh.
- They decrease during sleep and when the limb is actively being used.
- They tend to diminish when a gesture is made voluntarily.
Tremors are one of the most embarrassing, visible and well-known symptoms of Parkinson’s disease.
Tremors usually only affect one side of the body, especially in the early stages of Parkinson’s, but both sides can be affected as the disease progresses. Their intensity usually stabilizes after a certain amount of time.
Tremors affect 80% of people with Parkinson’s disease.
Several neurological conditions can cause tremors and having tremors does not necessarily mean you have Parkinson’s disease.
Tremors associated to Parkinson’s disease are resting tremors, which occur when the body part is inactive. This typically starts in one hand, fingers, or a foot. Tremors can also affect the jaw or tongue, which can lead to communication difficulties.
As with stiffness, Parkinson’s tremors mainly affect one side of the body.
If you think you have resting tremors, consult your doctor. They will perform tests to exclude any other condition often confused with Parkinson’s disease.
Many types of involuntary movements are often confused with parkinsonian tremors. While these may not be related to your disease or treatment, they can sometimes be direct indicators of your medication’s effectiveness.
For example, tremors in one leg when it is in a particular position with the heel lightly resting on the ground affect the whole population and are not specific to Parkinson’s disease.
On the other hand, exaggerated, chaotic and fluid movements, which sometimes resemble dance moves, are dyskinetic movements. These are not repetitive movements and do not have a specific pattern. They are caused by an overdosage of levodopa. They typically start 30 minutes to one hour after taking the drug and their intensity fluctuates during the overdose period.
As for cramps in toes or feet, these usually occur at night or in the morning and indicate insufficient levodopa dosage. These are abnormal muscle contractions (dystonia) that induce often painful abnormal positions. These movements usually begin several hours after taking medication and increase until the next medication dose takes effect.
Tremors are caused by a decrease in dopamine levels associated with the death of dopaminergic brain neurons. When this level becomes critical, automatic muscle movements are affected and tremors begin to appear.
In the early stages of Parkinson’s disease, some people can reduce tremors by pressing or rolling a ball, pen or other small object. Tremors can also increase during stressful situations, during which you should take some time to breath and relax.
Tremors are more difficult to control during the more advanced stages of the disease. Here are some ways to better manage your tremors if they interfere with daily activities:
- Write on a keyboard rather than by hand
- Use speech-to-text cell phone apps
- Drink with a straw
- Use heavier utensils. If this does not help, you can purchase electronic utensils designed to counter your tremors
- Purchase clothing and shoes that are easy to put on
Of all Parkinson’s disease symptoms, the effect of drug treatments on tremors are the most unpredictable.
When starting Parkinson’s medicine treatments, you and your family should not judge their effectiveness by decreased tremors, but the simplification of daily tasks.
Some medication, such as anticholinergics and propranolol, can be specifically used to treat tremors. However, they are not recommended for the elderly.
When tremors become too overwhelming, deep brain stimulation can be considered. This is the most effective and reliable treatment available for tremors.
Some medications can make your tremors worse. Discuss this with your neurologist.
Tremors usually appear in the fingers and can spread to the hand, jaw and one foot.
Like most Parkinson’s symptoms, tremors occur on one side of the body. It is even possible that these never reach the other side of your body.
Parkinson’s disease progresses slowly. The limbs affected and the intensity of tremors are difficult to predict, though the intensity tends to stabilize over time.
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