What causes tremor besides Parkinson’s disease?

Dr. Nader Pouratian, MD

Besides Parkinson’s disease, cerebellar diseases—tumors in the cerebellum, a stroke in the cerebellum, or genetic diseases that affect the cerebellum, such as spinocerebellar diseases -- can cause tremors. Strokes can cause tremor. Multiple sclerosis can cause a tremor.

Also, we take an extensive drug history because many medications can cause tremors: lithium, valproate (which is a seizure medicine), antipsychotics, and antidepressants. Other commonly used drugs can cause tremor, especially caffeine. I think everyone’s experienced that when they have too much coffee, they can get the shakes. Thyroid disease can cause tremor, and there’s something called enhanced physiologic tremor, so everybody has somewhat of a tremor.

Some people have more of a physiologic tremor than others, and that can become exaggerated in times of anxiety or different situations, so we can have an enhanced physical tremor that actually isn’t pathological. It’s a normal phenomenon.

There are other conditions that cause tremor besides Parkinson's disease. For example, essential tremor is a different form of tremor. A person with a tremor and the following characteristics may have essential tremor rather than Parkinson's disease:

  • lifelong tremors
  • tremors in both hands instead of one hand
  • tremors that get really bad in social situations
  • tremors that sometimes get a little better with alcohol consumption
  • tremors in the head where the head bobs up and down
  • family history where other people in the family have these types of tremors in both hands or in their head

Following are characteristics of tremor and other things not related to tremor that can be more consistent with Parkinson's disease:

  • advanced age
  • tremor starts on one side
  • increased stiffness on the same side as tremor
  • tremor happens primarily at rest
  • tremor goes away with activity
  • decreased arm swing
  • worsening feeling of balance
  • sleep disturbances
  • constipation

All of these are good enough reasons to get an evaluation with a neurologist or a movement disorder specialist to find out if they could be related to Parkinson's disease.

Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified health care provider.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.