Tremor Treatment in Hyderabad
Shaking hands are not always Parkinson's. Accurate tremor classification is the first step — and most types of tremor respond very well to treatment.
Tremor is an involuntary rhythmic shaking movement of any body part. It is one of the most common movement disorders, affecting approximately 5% of people over 65 years old. Many patients with tremor are unnecessarily alarmed, believing they have Parkinson's disease. In reality, essential tremor is much more common than Parkinson's, is not degenerative, and responds well to treatment. Accurate classification by a neurologist is essential.
Key Points
- Essential tremor (ET) is the most common movement disorder — 10 times more common than Parkinson's.
- A neurologist can distinguish essential tremor from Parkinson's tremor at the bedside — they need different treatment.
- Propranolol and primidone are first-line for ET, effective in 50-70% of patients.
- Alcohol temporarily suppresses ET — using it as treatment leads to alcohol dependence.
- DBS of the thalamus is highly effective for severe, medication-resistant tremor.
10x
more common than Parkinson's (essential tremor)
Source: International Tremor Foundation
70%
respond to first-line drug therapy
Source: AAN Practice Guidelines
Types of Tremor — Which Do You Have?
Essential Tremor (Most Common)
Action tremor — occurs during voluntary movement (writing, holding a cup, eating). Typically bilateral. Worsens with caffeine and stress. Often improves with small amounts of alcohol. Family history common.
Resting Tremor (Parkinson's)
Tremor at rest — present when the limb is fully relaxed, disappears with voluntary movement. Typically starts in one hand. Associated with slowness and stiffness. Requires Parkinson's assessment.
Intention Tremor (Cerebellar)
Tremor that worsens as the hand approaches a target — visible on finger-to-nose testing. Caused by cerebellar disorders. Associated with incoordination and balance problems.
Physiological Tremor (Normal)
A fine, fast tremor present in all humans — exaggerated by anxiety, caffeine, certain medications (salbutamol, lithium, valproate), hyperthyroidism, and fatigue.
Task-Specific Tremor
Tremor that occurs only during a specific task — most commonly writer's cramp (primary writing tremor). Localised, task-specific tremor with a different treatment approach.
Tremor Treatment at Sri Anand Hospital
Accurate Clinical Classification
We classify tremor type through careful neurological examination — observing tremor characteristics, testing at rest, with action, and during tasks, and performing gait and coordination tests.
Essential Tremor Medication
Propranolol and primidone are the first-line evidence-based treatments for essential tremor, reducing amplitude by 50–60% in many patients. We titrate carefully to minimise side effects.
Thyroid and Medication Review
We always check thyroid function and review all current medications — many common drugs cause or worsen tremor, and stopping them resolves it completely.
Botulinum Toxin for Focal Tremors
For head tremor, voice tremor, and task-specific tremors, localised botulinum toxin injections can be very effective when medications fail.
Physiotherapy for Functional Tremor
Functional tremor (psychogenic tremor) — which accounts for a significant proportion of tremor presentations — responds best to physiotherapy and psychoeducation, not medication.
Why Choose Sri Anand Hospital?
Treated by: Dr. Anand Karnam · DrNB (Neurology) · Movement Disorders Specialist
"The most important thing with tremor is distinguishing essential tremor from Parkinson's tremor from dystonic tremor — they look similar but require completely different treatment. Most patients Google tremor = Parkinson's and are relieved to learn it is often a benign condition."
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Sri Anand Child & Neuro Hospital · Open 24/7 · Chanda Nagar, Hyderabad