Articles - Use the links below to find two articles by Professor Leslie J Findley, MD., F.R.C.P, consultant neurologist, and medical advisor to the National Tremor Foundation.

LIVING WITH THE SHAKES

Tremor - or uncontrollable shaking - is a normal phenomenon experienced by us all. It is a necessary "by-product" of normal brain and nervous system functions and usually appears during times of stress. There are many mechanisms behind this, including the production of adrenaline.

Adrenaline is a chemical which stimulates the brain and peripheral nervous system and is the body's natural response to dealing with pressure.

Some people are born with a tendency to tremor and others acquire the condition during their lifetimes, possibly as a result of another bodily dysfunction. Such causes include thyroid, metabolic, brain or nervous system diseases.

Pathological, or symptomatic tremor, is more common, affecting up to five per cent of the population.

The commonest form of the shakes is called Essential Tremor (ET). About half those with ET have inherited it. It usually starts in the upper limbs during teenage years and once developed, it never stops. ET is not associated with any known degenerative process is the nervous system, but has to be distinguished from a number of disorders which can be present.

Over a lifetime, ET slowly gets worse. About a third of patients will develop head tremor as well as limb tremor.

A number of medications can be used to try and ease the problem, although there are no drugs which specific effects, and all carry the risk of side-effects. It is still not clear what underlying mechanisms produce this form of tremor and until we have more knowledge, it is difficult to see how we can improve management of the condition.

Apart from inherited ETs, there are several neurological disorders which have a tremor as a major feature. The most common is Parkinson's Disease (PD).

Other neurological disorders can also produce tremors.

In the last few years, there has been a renaissance of interest in using surgical approaches to try and manage intractable tremors.

Newer techniques of neuro-surgery have made the procedures much safer. They are now currently being evaluated.

Owing to the recognised need for diagnostic information, support and advice, and in order to raise money for research, the International Tremor Foundation was set up and in the UK, this has become the National Tremor Foundation, which is a registered charity with the sole purpose of providing services to those with tremor of all types.