Tremor

Many tremors are mild enough not to require treatment or may go away on their own. But for more frequent and disruptive tremors, there are certain medications, physical therapies, and nonsurgical and surgical methods available to reduce the likelihood of occurrence of tremors or stop them completely.

Medications

Medications for treating tremors may be the same ones used to treat essential tremors and Parkinsonian tremors, including:

• Beta-blockers such as propranolol, atenolol, metoprolol, nadolol, and sotalol
• Anti-seizure medications such as primidone, gabapentin, and topiramate
• Anti-anxiety medications such as Xanax, Klonopin, Valium, and Ativan, can be habit-forming and should be taken with caution
• OnabotulinumtoxinA (Botox®) injections, which may help with head and vocal tremors

Physical therapy

Patients with tremor can benefit from physical or occupational therapy treatments, which will show patients specific exercises to help improve muscle control, strength, and coordination.

Physical therapists can help to:

• Evaluate motor skills and muscle strength and create an individualized program
• Recommend adaptive devices, including thicker writing pens, heavier utensils and glasses, and a cane or other walking equipment if balance is impaired.
• Develop a plan to modify activities, simplify work, and conserve energy

Surgery

If tremors are disabling and don’t respond to other treatment methods, deep brain stimulation (DBS) is a surgical option.

During DBS, doctors insert a thin electrical probe into the thalamus area of the brain (which acts as a relay station for movement and sensory information coming from the body to the brain). A wire from the probe runs under the skin to a pacemaker-like device implanted near the collarbone. The device transmits electrical pulses to the thalamus to interrupt the signals causing the tremors.

Nonsurgical methods

High-intensity focused ultrasound is an advanced precision treatment for patients with severe forms of tremor. During this treatment, sound waves travel through the skin and skull. The waves heat up and destroy brain tissue in an area of the thalamus to stop tremors from occurring.