The Northwell Health Movement Disorders Center is one of the largest and most comprehensive programs on Long Island for the evaluation, diagnosis, and medical and surgical treatments of movement disorders, including all types of tremors. We specialize in providing the most advanced treatments for all types of tremors.
If you are experiencing only mild tremors, you may not require treatment. If your shaking has increased, and you are experiencing difficulty in living your life or accomplishing your daily tasks, your doctor will discuss treatment options with you which may include medications, therapy or surgery.
Medications for tremors may include:
- Anti-seizure medications
- Beta blockers
Physical therapy may be recommended to sharpen your coordination, increase your muscle strength and improve your overall ability to control your movements. An occupational therapist may offer solutions to adjust to living with tremors.
If your tremors are severe and extremely disabling, your doctor may discuss with you the option of deep brain stimulation surgery. In this procedure, your surgeon will insert a thin electrical probe into the area of your brain which is causing the tremors. This wire is connected to a device which is similar to a pacemaker. About two weeks after the brain surgery, the pacemakers will be turned on and programming will begin. Many patients experience very rapid improvement in many of their symptoms. Other symptoms can take a few months to improve. The programming of the pacemaker is a very individually tailored experience so predictions of improvement vary based on the type and severity of symptoms being treated. In general, most patients experience significant improvement by six months from the date of the surgery.
There are many different types of tremors, with causes ranging from neurological, biological and psychological to environmental. Symptoms can sometimes be alleviated by addressing the underlying cause, or through medications, diet, lifestyle or surgical interventions.
If medication is required to treat your tremor, it’s important to consider the possibility of side effects which may include:
- Anti-seizure medications – Side effects may include feelings of unsteadiness, dizziness and nausea.
- Beta blockers – Side effects may include depression and an exacerbation of symptoms of depression. These medications should not be used if you have asthma, emphysema or congestive heart failure.
- Tranquilizers – Side effects may include a risk of dependence and sedation.
Botox – Side effects may include muscle weakness, droopy eyelids, allergic reactions, difficulty swallowing, shortness of breath and headache.
The process of diagnosing tremors begins with a comprehensive evaluation. Diagnosis of movement disorders is based on a clinical exam, a thorough assessment of your personal medical history and a detailed review of your family history. We also use a variety of screening procedures to determine your condition, although there is no single medical test to diagnose tremors. Your doctor will recommend a neurological examination to assess your nervous system and its ability to function properly. You may also undergo laboratory testing to establish if you are being affected by any medications and their side effects, metabolic problems, alcohol in your blood stream and levels of chemical in your blood which may be causing tremors.
Other tests such as brain scans may be ordered by your doctor. Brain scans are imaging techniques used to diagnose a wide range of conditions affecting the brain and may be recommended by your doctor. Types of brain scans include computed tomography (CT scan), magnetic resonance imaging (MRI scan) and positron emission tomography (PET scan).
The majority of patients experience a reduction in tremor amplitude with medication treatment. If deep brain stimulation is recommended, you will likely gain significant improvement in symptoms and improved quality of life. However, you may still require medication to manage symptoms such as seizures.