Functional Tremor: Signs, Causes, And How To Treat
Functional tremor is a condition where uncontrollable shaking occurs, often triggered by emotional or psychological stress. It is not caused by a neurological disorder but rather by the brain's response to stress or emotional trauma. This type of tremor can be challenging to diagnose due to its connection to mental health factors. Understanding the underlying emotional triggers is essential in managing functional tremor effectively. By addressing the psychological aspects, individuals with functional tremor can work towards reducing the frequency and intensity of their tremors and improving their overall quality of life.
What Are the Symptoms of Functional Tremor?
Symptoms may include rhythmic shaking that worsens with stress, improves with distraction, and may disappear during sleep. Tremors can affect daily activities like writing or holding objects. Seeking medical evaluation is essential for proper diagnosis and management.
- Shaking or trembling in your hands, arms, legs, or head that happens when you try to move or hold them still.
- Difficulty with fine motor tasks like writing, pouring a drink, or using utensils due to uncontrollable shaking.
- The tremors may come and go, varying in intensity throughout the day and can be triggered by stress or anxiety.
- Feeling like your body is vibrating or twitching involuntarily, especially during times of heightened emotions or fatigue.
- Tremors that improve or disappear completely when you are distracted or engaged in a different activity, only to return when you focus on the affected body part.
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Get A Second OpinionCauses of Functional Tremor
It is believed to result from a miscommunication between the brain and the muscles, leading to involuntary shaking or trembling. Factors such as past trauma, anxiety, or depression may play a role in the development of functional tremor.
- Emotional stress and anxiety can trigger functional tremors in individuals, leading to involuntary shaking movements.
- Certain medications, such as asthma drugs or antidepressants, may cause functional tremors as a side effect in some patients.
- Neurological conditions like Parkinson's disease or multiple sclerosis can sometimes manifest as functional tremors in affected individuals.
- Thyroid disorders, such as hyperthyroidism, can contribute to the development of functional tremors due to hormonal imbalances.
- Previous traumatic experiences or post-traumatic stress disorder (PTSD) can be associated with functional tremors in some individuals as a psychological response.
Types Of Functional Tremor
These tremors are often inconsistent and may disappear at rest. Understanding the different types of functional tremors can help healthcare providers accurately diagnose and manage this condition.
- Postural tremor is a type of functional tremor that occurs when holding a position against gravity, such as when extending the arms forward. This tremor typically disappears when the affected limb is at rest.
- Kinetic tremor manifests during voluntary movements, like reaching for an object or writing. It can vary in intensity and may worsen with certain tasks, but tends to improve when the affected limb is not actively engaged.
- Task-specific tremor is a subtype of functional tremor that occurs only during certain activities, such as playing a musical instrument or applying makeup. This tremor is often reproducible with specific tasks and may not be present during other daily activities.
- Intention tremor is characterized by tremors that occur as the individual approaches a target during a voluntary movement, such as reaching for an object.
Risk Factors
Functional tremor risk factors include a history of psychological trauma, such as abuse or PTSD, as well as other mental health conditions like anxiety or depression. Individuals with a history of other functional neurological disorders may also be at higher risk. Stressful life events, chronic illness, and female gender are additional factors that may contribute to the development of functional tremor.
- Psychological stress and emotional trauma are significant risk factors for developing functional tremor.
- History of anxiety disorders or other psychiatric conditions can increase the likelihood of experiencing functional tremor.
- Physical or sexual abuse in the past may contribute to the development of functional tremor in some individuals.
- Chronic illness or medical conditions, such as fibromyalgia or irritable bowel syndrome, can be associated with an increased risk of functional tremor.
- A family history of movement disorders or tremors may predispose individuals to developing functional tremor.
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Book an AppointmentDiagnosis of Functional Tremor
To diagnose functional tremor, your doctor will perform a physical exam and may order tests to rule out other conditions. They will observe your tremor and assess its characteristics. They may also use specific maneuvers to help differentiate functional tremor from other types of tremors. It's important to provide detailed information about your symptoms and medical history to help guide the diagnosis process accurately. Functional tremor can present a diagnostic challenge due to its complex nature. Various methods are used to diagnose functional tremor, including:
- Clinical evaluation: A thorough physical examination and detailed medical history can help in identifying characteristic features of functional tremor, such as variability in tremor severity and distractibility.
- Observation and video recording: Observing the tremor during specific tasks and recording it on video can provide valuable information about the tremor's characteristics and response to certain maneuvers.
- Electromyography (EMG): EMG can help differentiate functional tremor from other types of tremors by measuring muscle activity and identifying abnormal patterns that are suggestive of functional tremor.
- DaTscan imaging: DaTscan imaging can be used to assess dopamine transporter levels in the brain, helping to rule out neurodegenerative conditions such as Parkinson's disease, as it can distinguish between functional tremor and tremors caused by dopamine deficiencies.
Treatment for Functional Tremor
Treatment options for functional tremor may include physical therapy to improve muscle control and coordination, psychotherapy to address underlying emotional factors, and medications to manage symptoms. Deep brain stimulation and botulinum toxin injections are also potential interventions. It's important to work closely with your healthcare team to determine the best approach for managing your functional tremor and improving your quality of life.
- Physical therapy can be an effective treatment for functional tremor, focusing on exercises that improve coordination and muscle control to help reduce tremors and enhance overall function.
- Cognitive-behavioral therapy (CBT) is often recommended for functional tremor to address any underlying psychological factors that may be contributing to the tremors, helping patients better manage stress and anxiety that can exacerbate symptoms.
- Medications such as beta-blockers or benzodiazepines may be prescribed to help alleviate the symptoms of functional tremor, although their effectiveness can vary from person to person.
- Deep brain stimulation (DBS) is a surgical procedure that involves implanting electrodes in the brain to help regulate abnormal electrical signals that may be causing the functional tremor.
Frequently Asked Questions
How can functional tremor be identified through its signs?
Functional tremor can be identified by its variable frequency and amplitude, abrupt onset or cessation with distraction, and inconsistency during examinations.
What are the recommended do's and don'ts for managing functional tremor?
Do: Engage in physical therapy, stress management techniques, and relaxation exercises. Don't: Ignore symptoms or self-diagnose without consulting a healthcare professional.
Can functional tremor lead to other health issues?
Functional tremor can impact daily activities but typically doesn't lead to other health issues. Treatment focuses on managing symptoms and underlying stressors.
What steps should I take for the management of functional tremor?
Treatment may include physical therapy, counseling, and stress management techniques. Medications and deep brain stimulation can also be considered in severe cases.
Are there any signs that functional tremor might recur after treatment?
Functional tremor recurrence signs include reappearance of tremors during stress, improvement with distraction, presence of other functional neurological symptoms.
