Dear Doctor: What is Tremor and What Are My Treatment Options?

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What is tremor?

Known as shaking, tremor is an involuntary motion of the arms, legs or head. There are two types of tremors. An action tremor (in the arms) happens when you shake while trying to use your arms during activities like eating, writing or using a screw driver. A rest tremor is involuntarily shaking when your arms are not moving from activities like sitting, resting or watching TV.

Is tremor always due to Parkinson’s disease?

No. Tremor can be the result of Parkinson’s disease, but also other disorders such as essential tremor, dystonia or even medications.

How can we differentiate them?

It’s difficult to distinguish. Tremor can be due to many causes: Parkinson’s disease, essential tremor and others. It would be best to see a movement disorder specialist, like a neurologist that specializes in movement disorders, to get the right diagnosis. Treatments are not the same for all types of tremor.

What treatments are there?

Treatments vary based on the cause of tremor. But it can include medications, injections of botulinum toxins (such as Botox®) or brain surgery called Deep Brain Stimulation. Your movement disorder specialist can tailor the treatment to the type of tremor you have and its impact on your daily life.

Brain surgery? That sounds frightening!

Not at all. Deep Brain Stimulation has been used in Europe for more than 30 years, and has been FDA approved in the U.S. for more than 20 years. At our center, we perform one or two of these surgeries per week. Any potential candidates for the surgery will need to be assessed first by a movement disorder specialist to make sure that they will obtain the maximum benefits, as not all tremors are treatable by this surgery.

Dr. Raja Mehanna is a board-certified neurologist at UT Physicians who specializes in movement disorders. To schedule an appointment, please call 832-325-7080, or go to

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