Tremor causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Naresh Mullaguri, M.B.B.S. [2] Kiran Singh, M.D. [3]

Overview

Tremor^[1] is generally caused by problems in parts of the brain or spinal cord that control muscles throughout the body or in particular areas, such as the hands. Neurological disorders or conditions that can produce tremor include multiple sclerosis, stroke, traumatic brain injury and neurodegenerative diseases that damage or destroy parts of the brainstem or the cerebellum. Other causes include the use of some drugs (such as amphetamines, caffeine, corticosteroids, and drugs used for certain psychiatric disorders), alcohol abuse or withdrawal, mercury poisoning, overactive thyroid or liver failure. Tremors can be an indication of hypoglycemia, along with palpitations, sweating and anxiety. Tremor can also be caused from lack of sleep, vitamins, or having too much stress. Deficiencies of magnesium and vitamin B1 have also been known to cause tremor or shaking which resolves when the deficiency is corrected. See magnesium in biology. Some forms of tremor are inherited and run in families, while others have no known cause. Tremors can also be caused by some spider bites i.e. the redback spider of Australia.

Tremor can result from other conditions as well. Alcoholism, excessive alcohol consumption, or alcohol withdrawal can kill certain nerve cells, resulting a tremor known as asterixis. Conversely, small amounts of alcohol may help to decrease familial and essential tremor, but the mechanism behind this is unknown. Tremor in peripheral neuropathy may occur when the nerves that supply the body’s muscles are traumatized by injury, disease, abnormality in the central nervous system, or as the result of systemic illnesses. Peripheral neuropathy can affect the whole body or certain areas, such as the hands, and may be progressive. Resulting sensory loss may be seen as a tremor or ataxia (inability to coordinate voluntary muscle movement) of the affected limbs and problems with gait and balance. Clinical characteristics may be similar to those seen in patients with essential tremor.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	2,4-Dichlorophenol, 3-Aminopyridine, 4-Aminopyridine, acetylene Dichloride, acidic dry cell batteries, acrylamide, agrocide, agronexit, alcohol, amidithion,amiton, aparasin, aphtiria, arsenic poisoning, athyl-gusathion, atropine, Azinfos-methyl, Azinfosethyl, Azinophos-methyl, Azinphos, Azinphos-ethyl,Azinphos-methyl, Azinphosmetile, Azothoate, Benhexol, Benoxafos, Bexol, Biphenyl, Bromide, Bromoform, Bromophos, Bromophos-ethyl, Cadusafos, Caffeine poisoning, Carbinoxamine, Carbon disulfide, Carbon tetrachloride, Carbophenothion, Chlordane, Chlordecone, Chloresene, Chlorfenvinphos, Chloromethane, Chloropyrifos, Chlorpyrifos methyl, Cresols, Cresylic acid, Cyanthoate,Phenothrin, DDD, DDT, Demeton, Demeton-methyl, Demeton-O, Demeton-O-methyl, Demeton-S-methyl, Demeton-S-methylsulphon, Dialifos, Diazinon, Diborane, Dichlorvos, Dimethoate, Dioxathion, Diquat dibromide, Disulfiram Disulfoton, Endosulfan, Endothion, Epichlorohydrin, Ethion, Ethoate-methyl, Ethoprophos, Ethyl mercaptan, Ethyl-guthion, Ethylbenzene, Ethylene Dichloride, Etrimfos, Ezogabine, Fenchlorphos, Fenitrothion, Fensulfothion, Fenthion, Fipronil, Fluoridated toothpaste, Fonophos, Food additives - MSG, salicylate, sulfite, Formothion, Gasoline, Glaze, Glufosinate, Glycol ether, Guthion (ethyl), Heptachlor, Heptenophos, Iodofenphos, Ivermectin, Lead, Lindane, Lobelia poisoning, Malathion, Manganese, Mecarbam, Metaproterenol, Metaldehyde, Methacrifos, Methamidophos, Methidathion, Methylene chloride, Metiltriazotion, Mevinphos, Mercury poisoning, Mescal poisoning, Minamata disease, Monocrotophos, Monosodium methanarsenate, Nicotine poisoning, Organophosphate insecticide poisoning, Omethoate, Oxazepam, Oxydeprofos, Oxydisulfoton, Parathion, Parathion Methyl, Phenkapton, Phenol, Phorate, Phosalone, Phosmet, Phosphamidon, Phosphine, Phoxim, Pirimiphos-methyl, Primiphos methyl, Prothidathion, Prothoate, Pyrethrin, Pyrimitate, Quinalphos, Quintiofos, RDX, Rotenone, Selenium poisoning, Sea Hare poisoning, Sophamide, Sulfotep, Sulfuryl Fluoride, Terbufos, Tetrachloroethane, Thallium, Thallium Sulfate, Thiometon, Tolclofos methyl, Toxaphene, Triazophos, Triazotion, Trichloroethylene, Trifenfos, Tubatoxin poisoning, Vamidothion, Wilson's disease
Dermatologic	No underlying causes
Drug Side Effect	Amiodarone, Amphetamine, Artemether and lumefantrin, Butorphanol, Ciclosporin, clozapine, caspofungin acetate, Cidofovir, Dimercaprol, Disulfiram , Dobutamine, Dopamine, Dopexamine, Efavirenz, Ephedrine, Epinephrine, Eslicarbazepine acetate, Febuxostat, Fluvoxamine, Glipizide, Glycerol phenylbutyrate,Haloperidol^[2], Margosa oil, Black Cohosh, Peppermint oil, Sabah vegetable, Isoprenaline, Isoproterenol (aerosol),Ivermectin, Lenalidomide, Levalbuterol, Lidocaine^[3], Nalmefene, Loxapine, Miglustat, Norepinephrine, Nabilone, Orphenadrine, Oxaprozin, Oxcarbazepine, Paroxetine, Phentermine, Pentamidine Isethionate, Phenylephrine, Pilocarpine, Pirbuterol, Ramucirumab, Rifaximin, Rizatriptan, Reproterol, Salbutamol, Sodium oxybate, Tacrolimus, Terbutaline, Trifluperidol, Valganciclovir hydrochloride, Valproic acid, Venlafaxine, Vilazodone, Thalidomide, Thallous Chloride Tl 201, Xamoterol
Ear Nose Throat	No underlying causes
Endocrine	Adrenal adenoma, Adrenal cancer, Adrenal incidentaloma, Adrenal tumor, Diabetes insipidus, Diabetes mellitus, High T4 syndrome, Hyperadrenalism, Hyperthyroidism, Toxic multinodular goiter, Pheochromocytoma, Pituitary tumors
Environmental	Minamata disease
Gastroenterologic	Cirrhosis of liver
Genetic	Chromosome 20p, partial duplication, Friedreich ataxia, Huntington's Disease, Mental retardation X-linked Cabezas type
Hematologic	Chediak-Higashi syndrome
Iatrogenic	Neuroleptic malignant syndrome, Serotonin Syndrome, Ureterosigmoidostomy
Infectious Disease	Central Nervous system protozoal infections like Toxoplasmosis, Sleeping sickness (East african), Sleeping sickness (West african), Meningoencephalitis, Creutzfeldt-Jakob disease , Krabbe leukodystrophy, Neurosyphilis, Ramsay Hunt syndrome
Musculoskeletal / Ortho	Amish nemaline myopathy
Neurologic	Alcoholic cerebellar degeneration, Alcoholic intoxication, Alzheimer's disease, Amyloidosis, oculoleptomeningeal , Aniridia cerebellar ataxia mental deficiency, Anxiety, Basal ganglia calcification, Benign essential tremor, Bovine spongiform encephalopathy, Brain Fag syndrome, Central nervous system protozoal infections, Cerebellar degeneration, Cerebellar disease, Cerebrovascular accident, Creutzfeldt-Jakob disease, Dementia With Lewy Bodies, Diencephalic syndrome, Drug-induced parkinsonism, Dystonia 1, torsion, autosomal dominant, Dystonia musculorum deformans, Dystonia, Essential tremor, Fatal familial insomnia, Friedreich ataxia, Frontotemporal dementia, Huntington's Disease, Idiopathic dystonia DYT1, Parkinson's disease, Krabbe leukodystrophy, Leukoencephalopathy -- metaphyseal chondrodysplasia, Meningoencephalitis, Mental retardation, X-linked, Cabezas type, Metabolic encephalopathy, Metachromatic leukodystrophy, Multiple sclerosis^[4], Multiple system atrophy, Myoclonic epilepsy benign, Neuronal intranuclear inclusion disease, Neurosyphilis, Normokalemic periodic paralysis, Olivopontocerebellar Atrophy, Oppenheim's dystonia, Pallidopyramidal syndrome, Parkinsonism, Pelizaeus-Merzbacher disease, Pick's disease of the brain, Spastic paraparesis deafness, Spinocerebellar ataxia
Nutritional / Metabolic	Arginase deficiency, Fucosidosis, Ceroid lipofuscinosis, Holocarboxylase synthetase deficiency, Methylmalonic acidemia with homocystinuria, Motor and cognitive disorder due to sepiapterin reductase deficiency, Mucolipidosis, Purine nucleoside phosphorylase deficiency, Sialidosis, Uraemia, Vitamin B1 deficiency
Obstetric/Gynecologic	No underlying causes
Oncologic	Adrenal adenoma, Pituitary tumors, Pheochromocytoma, Adrenal incidentaloma
Opthalmologic	Optic atrophy
Overdose / Toxicity	Dexedrine, Methamphetamine, Lithium toxicity^[5]
Psychiatric	Hysteria, Anxiety, Psychogenic movement disorders
Pulmonary	Respiratory failure
Renal / Electrolyte	Hypoglycemia, Hypomagnesemia, Normokalemic periodic paralysis
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Shy-Drager syndrome, Senile, Roussy-Levy syndrome, Salvioli syndrome, Wolfram syndrome, Primary orthostatic tremor^[6], Physiologic tremor, Lindsay-Burn syndrome, Lhermitte-McAlpine syndrome, Kennedy's disease, Hypothermia, Da Costa's syndrome, Combarros Calleja Leno syndrome, Cockayne syndrome

Causes in Alphabetical Order

3

References

↑ Zeuner KE, Deuschl G (2012). "An update on tremors". Curr. Opin. Neurol. 25 (4): 475–82. doi:10.1097/WCO.0b013e3283550c7e. PMID 22772877. Unknown parameter |month= ignored (help)
↑ Collins-Praino LE, Podurgiel SJ, Kovner R, Randall PA, Salamone JD (2012). "Extracellular GABA in globus pallidus increases during the induction of oral tremor by haloperidol but not by muscarinic receptor stimulation". Behav. Brain Res. 234 (1): 129–35. doi:10.1016/j.bbr.2012.06.011. PMID 22728308. Unknown parameter |month= ignored (help)
↑ Diaz J, Bernasinski M, Malinovsky JM (2012). "[Reversal of neurologic symptoms related to lidocaine toxicity with a lipid emulsion administration]". Ann Fr Anesth Reanim (in French). 31 (7–8): 647. doi:10.1016/j.annfar.2012.05.001. PMID 22749556.
↑ Karmon Y, Morrow SA, Weinstock A, Hojnacki D, Weinstock-Guttman B (2012). "Limb ataxia originating from peri-central sulcus demyelinating lesion in multiple sclerosis". J. Neurol. Sci. 320 (1–2): 136–40. doi:10.1016/j.jns.2012.05.039. PMID 22698481. Unknown parameter |month= ignored (help)
↑ Bogers CH, Boshuisen ML, Kok JS, Knegtering H (2012). "[Neurotoxicity in elderly patients being treated with lithium: is there a reason to adjust the dosage administered?]". Tijdschr Psychiatr (in Dutch; Flemish). 54 (4): 359–69. PMID 22508354.
↑ Virmani T, Louis ED, Waters C, Pullman SL (2012). "Familial orthostatic tremor: an additional report in siblings". Neurology. 79 (3): 288–9. doi:10.1212/WNL.0b013e31825fdfb3. PMID 22764256. Unknown parameter |month= ignored (help)
↑ Chemaly RE, Moussalli AS (2012). "Parkinsonian syndrome as a complication of systemic lupus erythematosus. Report of a case and review of the literature". J Med Liban. 60 (2): 103–5. PMID 22919866.

[pmid22772877-1] Zeuner KE, Deuschl G (2012). "An update on tremors". Curr. Opin. Neurol. 25 (4): 475–82. doi:10.1097/WCO.0b013e3283550c7e. PMID 22772877. Unknown parameter |month= ignored (help)

[pmid22728308-2] Collins-Praino LE, Podurgiel SJ, Kovner R, Randall PA, Salamone JD (2012). "Extracellular GABA in globus pallidus increases during the induction of oral tremor by haloperidol but not by muscarinic receptor stimulation". Behav. Brain Res. 234 (1): 129–35. doi:10.1016/j.bbr.2012.06.011. PMID 22728308. Unknown parameter |month= ignored (help)

[pmid22749556-3] Diaz J, Bernasinski M, Malinovsky JM (2012). "[Reversal of neurologic symptoms related to lidocaine toxicity with a lipid emulsion administration]". Ann Fr Anesth Reanim (in French). 31 (7–8): 647. doi:10.1016/j.annfar.2012.05.001. PMID 22749556.

[pmid22698481-4] Karmon Y, Morrow SA, Weinstock A, Hojnacki D, Weinstock-Guttman B (2012). "Limb ataxia originating from peri-central sulcus demyelinating lesion in multiple sclerosis". J. Neurol. Sci. 320 (1–2): 136–40. doi:10.1016/j.jns.2012.05.039. PMID 22698481. Unknown parameter |month= ignored (help)

[pmid22508354-5] Bogers CH, Boshuisen ML, Kok JS, Knegtering H (2012). "[Neurotoxicity in elderly patients being treated with lithium: is there a reason to adjust the dosage administered?]". Tijdschr Psychiatr (in Dutch; Flemish). 54 (4): 359–69. PMID 22508354.

[pmid22764256-6] Virmani T, Louis ED, Waters C, Pullman SL (2012). "Familial orthostatic tremor: an additional report in siblings". Neurology. 79 (3): 288–9. doi:10.1212/WNL.0b013e31825fdfb3. PMID 22764256. Unknown parameter |month= ignored (help)

[pmid22919866-7] Chemaly RE, Moussalli AS (2012). "Parkinsonian syndrome as a complication of systemic lupus erythematosus. Report of a case and review of the literature". J Med Liban. 60 (2): 103–5. PMID 22919866.

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