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#3. Tremors that worsen when moving hand approaches a target, for example, to pick up a pencil or scratch one's nose. This relatively uncommon pattern is seen with damage to part of brain known as cerebellum, located in back of head.
To extent that underlying problem can be fixed, tremor will usually improve as well. So if someone's tremor is due to an overactive thyroid, tremor will improve when thyroid problem is corrected. If a tremor is due to Parkinson's disease, then it will get better with medication for this condition. And if medication itself is causing problem, then a dose-reduction or substitution of another drug might do trick.
What if an underlying cause is not found, or correction of an underlying problem doesn't make tremor go away? Treatment might still be available. In case of tremors most evident with hands in air, certain medications might provide meaningful improvement, including primidone (brand name Mysoline), propranolol (Inderal), metoprolol (Lopressor) and gabapentin (Neurontin).
People with anxiety (inner nerves) respond best to anxiety-relieving medications and counseling. But medications that relieve anxiety do not help tremors (outer nerves) much, except to extent that they make patient drowsy. This is because all tremors improve with drowsiness. However, being perpetually drowsy is not a favorable trade-off for controlling tremor.
Who should get treated? It's an individual decision. Assuming that underlying problems have already been screened for, symptomatic treatment of inner nerves or outer nerves depends on answers to two questions:
#1. Does symptom cause distress? #2. Does symptom interfere with usual activities?
An affirmative answer to either question means that treatment should be considered.
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher. For more health-related articles, see his website at: http://www.cordingleyneurology.com