Multiple Sclerosis: Managing MS-Related Tremors

Many people with MS experience some form of tremor, or uncontrollable shaking, which can occur in various parts of the body.

There are several types of tremor, including:

• Postural tremors. A person who has a postural tremor will shake while sitting or standing, but not while lying down.
• Intention tremor. Means there is no shaking when a person is at rest. The tremor develops as the person attempts to reach or grasp something or move a hand or foot to a precise spot. This is the most common and generally the most disabling form of tremor that occurs in people with MS.
• Nystagmus. A tremor that produces jumpy eye movements.

What Causes Tremors?

Tremors occur because of the damage along the complex nerve pathways that are responsible for movement coordination.

How Are Tremors Treated?

Tremors are one of the most difficult symptoms of MS to treat. To date, there have been no reports of consistently effective drugs to treat tremors. Varying degrees of success have been reported with agents such as the anti-tuberculosis agent, isoniazid (INH); the antihistamines Atarax and Vistaril; the beta-blocker Inderal; the anticonvulsive Mysoline; a diuretic Diamox; and anti-anxiety drugs Buspar and Klonopin.

Psychological Impact of Tremors

Tremors can have a tremendous emotional and social impact on a person. Unfortunately, people with severe tremors tend to isolate themselves to avoid embarrassment. Isolation can lead to depression and further psychological problems. A psychologist or counselor may be able to help a person with MS deal with these issues and become more comfortable in public. Talk to your doctor if you are having trouble coping with tremors.

Reviewed by the doctors at the Mellen Center for Multiple Sclerosis Research at The Cleveland Clinic.