Istanbul Tremor Treatment

Shaking hands is a problem faced by many people at different stages of their lives. Temporary tremors in the hands or any limb are not a problem. However, tremors, medically referred to as tremor, are a disease on their own in some patients, while others are associated with other diseases.

In this article, questions such as what causes tremors, what types of tremors, which tremors should be taken seriously, and which diseases are associated with tremor will be answered in detail.

What is Tremor?

The problem known as tremor in the society is medically called tremor. Tremor can be a problem on its own, or it can be a symptom of other diseases.

Tremors in the class of tremors, in the simplest terms, are rhythmic movement disorders that occur involuntarily. These movement disorders are divided into two main groups depending on whether the tremor occurs while stationary or while moving.

Tremors that occur when stationary, resting tremor; Tremors that occur while moving are classified as action tremors.

Tremors that occur while the person is sitting or standing in a fixed position are classified as resting tremor. It is also known as static tremor or Parkinson’s tremor.

Action tremor, on the other hand, occurs when the person is in motion. These tremors are divided into 4 groups. These; intentional tremor, postural tremor, isometric tremor, and task-specific tremor.

İstanbul Tremor (Titreme) Tedavisi

Intentional Tremor

These tremors occur during a purposeful physical activity. In fact, tremors appear when approaching the end of goal-directed activity.

What a good and understandable example of the potential tremors is the finger nose test or reaching into a glass of water. For example, a systematic tremor occurs when the patient reaches for a glass of water on the table.

These tremors disappear when they are stationary, that is, at rest. Such tremors are also seen in some patients in the form of shaking the head and trunk back and forth.

Postural Tremor

Postural tremors are observed during actions performed against gravity. For example, tremors observed in situations such as raising hands or feet fall into this class. In this type of tremor, emotions such as excitement, fear, and stress can be triggers.

Mission Specific Tremor

Tremors that occur while writing or playing a musical instrument, that is, while performing certain activities, fall into this class. In these types of tremors, tremors may not be seen in other activities where the same muscles are used.

For example, while some individuals experience tremor while walking, the same individual may not experience any tremor during running.

Isometric Tremor

It is the tremors that disappear when the arms are left loose and occur when the muscles are used. For example, tremors that occur when a heavy object is lifted are classified in this group.

In addition to this classification, tremors are divided into 7 categories, considering the conditions that cause tremor. These; essential, Parkinson, dystonic, orthostatic, cerebellar, psycholenic tremor.

Essential tremor is the most common type of tremor. Tremors of unknown origin in the hands, arms and legs are classified in this group.

Tremors due to Parkinson’s disease are in this class.

Dystonia tremor also occurs due to a disease such as Parkinson’s.

What Causes Tremor?

Shivering is not always considered a sign of illness or disease. For example, in stressful moments, everyone’s hands and feet may tremble. Or tremors are likely to be seen in cases of extreme excitement.

Tremors that are not considered normal are tremors that occur due to the central nervous system and are associated with other diseases. It is recommended to consult a specialist neurologist in order to understand whether these movement disorders are related to another disease.

When to See a Doctor for Shivering Complaints?

As mentioned above, not all vibrations are a problem. In order for the tremor problem to be taken seriously, it should occur independently of situations such as instant excitement and stress, and should manifest itself not once but as repetitive situations.

In addition, tremors associated with diseases affect speech and tone of voice, occur in situations such as writing, eating, and using cutlery.

Cases where tremors should be taken seriously can be detected by the patient’s own follow-up.

İstanbul Tremor (Titreme) Tedavisi

How is the Diagnosis of Shivering Disease?

Diagnosis and treatment of tremors are carried out by neurologists. For diagnosis, the doctor first performs an oral and physical examination. Afterwards, a detailed neurological examination is performed. In this detailed examination, tendon reflexes, coordination, posture, muscle strength, muscle tone and tactile sensation are examined.

In addition, depending on the doctor’s request, physical activities such as eating and writing may be requested during the examination.

In addition to the doctor’s examination, blood tests, EMG, MRI and CT scans may be requested for the diagnosis of tremor.

A correct diagnosis of tremor can be made at the end of all these steps.

How to Treat Tremor – Shivering Disease? What are the Methods Used in the Treatment of Tremors?

A neurologist is consulted for the treatment of the tremor problem. In the Neuroup Neurology Clinics in Istanbul and Ankara, 4 different treatment methods are used for the treatment of tremor. These are;

  • Medication,
  • Physical therapy,
  • Botox treatment,
  • It is a brain stimulation therapy.

The treatment or treatments to be applied are determined by the cause of the tremor.

Medication Use in Tremor Treatment

The tremor problem is sometimes associated with other diseases. Drug therapy does not treat these diseases, but only the end of tremor. If the doctor deems it appropriate, drug treatment is applied at the end of the tremor.

Tremor Treatment with Physical Therapy Method

Treatment of tremor with physical therapy is not suitable for every patient. Whether this treatment is suitable for the patient is determined by a doctor’s examination. The aim of physical therapy is to strengthen the patient’s muscles and increase his control over the muscles.

Chills Treatment with Botulinum Toxin Injection

In the tremors that occur in the head area, treatment is carried out with Botilinum Toxin injection.

Tremor Treatment with Brain Stimulation

Some tremors cause loss of strength in patients. In such cases, the 3 treatment methods mentioned above are not suitable. In cases of power loss, treatment is carried out by sending controlled signals (warnings) to certain parts of the brain.

Who diagnoses tremor?

Tremor, also known as tremor disease, is diagnosed by a neurologist, as it is a neurological problem. It occurs with abnormal tremors in the hands and feet of the body, as well as around the eyes. Tremor has been observed frequently in recent years, especially in the 18-24 age group.

What happens if tremor is not treated?

Tremor, which is directly related to the brain, can be found in permanent brain damage if not treated. For this reason, Tremor, which is often confused with Parkinson's, has great long-term damage if not treated. For this reason, the disease should be examined under the supervision of a neurologist as soon as possible and the treatment process should be started.

Which clinic do I go to for tremor?

Tremor, also known as hand tremor, requires an appointment with a neurologist. It is possible to diagnose Tremor with the necessary tests during the appointment from the neurologist. Although hand tremor is often confused with Parkinson's, it has much greater risk factors if left untreated. Therefore, treatment should be started as soon as possible.

When is hand tremor dangerous?

Hand tremor can contain great dangers as the symptoms progress and start to cause difficulties in daily life. Therefore, hand tremor should be treated before it progresses. It is possible to make an appointment with a neurologist and start treatment for the treatment of hand tremor called tremor. Tremor; It can be caused by diseases such as epilepsy and hyperthyroidism.


[1] Agarwal, S., & Biagioni, M. C. (2020). Essential tremor. StatPearls [Internet].

[2] Dirkx, M. F., Zach, H., Bloem, B. R., Hallett, M., & Helmich, R. C. (2018). The nature of postural tremor in Parkinson disease. Neurology, 90(13), e1095-e1103.

Tremor Treatment Doctors

Prof. Dr. M. Zülküf ÖNAL
Prof. Dr. M. Zülküf ÖNAL
Neurologist Süreyya ATAUS
Neurologist Süreyya ATAUS