About one third of people with multiple sclerosis may have tremor to some degree. For some people it can be a relatively mild problem with coordination (ataxia), but for others it can be one of the most disabling symptoms of MS.
What is tremor?
Tremor is involuntary, uncontrolled movements. In multiple sclerosis, the type of tremor that is most frequently experienced is intention tremor or cerebellar tremor. This is a tremor that worsens as the individual uses the affected limb, for instance the arm shaking as someone reaches for an object or tries to touch their nose. Some people may experience postural tremor, which occurs when a person is maintaining a posture, such as sitting up.
What causes of tremor in MS?
The exact mechanism of tremor is unknown but is thought to be due to damage in the cerebellum, the area of the brain responsible for coordinating movement. Stress and anxiety can make tremor worse.
How is tremor treated?
Adaptation is a key element to coping with tremor and an occupational therapist may be able to offer advice.
Drug therapy has limited benefits. Beta-blockers may have some effect. Botulinum toxin has been used with some success to treat intrusive head tremor in people with MS.
Physiotherapy treatment can also show limited improvement.
Surgery may be used in severe cases of tremor.
Deep brain stimulation or thalamic stimulation, which has been used successfully in treatment of Parkinson's Disease, may also offer a new approach. A thin wire is surgically implanted into the brain with a battery-operated pulse generator implanted near the collarbone that sends continuous electrical pulses to the brain blocking brain signals.
Last updated: 20 August 2014
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