Parkinson’s Disease

This disorder is characterized by shaking that is constant at rest and improves when the person reaches out for something. Parkinson’s disease is often accompanied by slowness of movement, muscle rigidity and abnormal gait. Loss of balance may also occur in this disease.

Tremors along with loss of balance and abnormal walking pattern are usually seen in Parkinson’s disease. Circular walking may imply a neurological imbalance between two sides of the brain. It may happen due to more damage of brain cells on one side as compared to the other.

Loss of balance and walking abnormalities are also seen with disorders such as cerebellar disease, dementia, hypothyroidism, medications and stroke. These conditions need to be ruled out before confirming the diagnosis.

Other Causes of Tremors

Other causes of tremors include:

  • Too much coffee or other caffeine-containing drink
  • Excessive alcohol consumption, alcoholism, or alcohol withdrawal
  • Stress
  • Normal aging
  • Cocaine use
  • Essential tremor
  • Drugs such as amphetamines, antipsychotics, and lithium toxicity, phenothiazines, or phenytoin, valproic acid, and cyclosporine
  • Insulin overdose in diabetics (hypoglycemia)
  • Wilson’s disease

Diagnostic Tests

Investigations that may be performed include:

  • Blood tests – CBC, blood differential, thyroid function tests, urine and glucose test
  • Head CT scan
  • MRI of the head

Treatment

Treatment will depend according to the underlying cause. There are many medications available for disorders such as Parkinson’s disease.
For hand tremor caused by stress, try to relax.

For essential tremors, there are numerous medications that may be effective in controlling symptoms. These include beta-blockers, Gabapentin, Mysoline and others. Caffeine (in substances such as coffee and soda) and other stimulants should be avoided because they commonly worsen tremors.

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