MS Tremors Explored: Classifications, Remedies, and Further Insights
Tremors are a common symptom for people living with Multiple Sclerosis (MS). These involuntary muscle contractions and relaxations can affect various parts of the body, including the head, torso, arms, legs, and vocal cords.
There are two main types of tremors that people with MS may experience: intention tremors and cerebellar tremors.
Intention Tremors
Intention tremors, as the name suggests, increase in intensity as a person moves towards a target. This type of tremor is characterized by a tremor that becomes more pronounced at the point of reaching the target. It is often accompanied by other cerebellar signs such as ataxia (lack of coordination), dysarthria (speech difficulties), and nystagmus (eye movement issues).
Cerebellar Tremors
Cerebellar tremors, on the other hand, are caused by damage or degeneration of the cerebellum, the brain region responsible for coordinating movement. This tremor is typically slow and rhythmic and may worsen with purposeful movement or posture maintenance.
Internal Tremors or Vibrating Sensations
In addition to visible tremors, people with MS may also experience internal tremors or vibrating sensations. These sensations manifest as internal shaking or buzzing and are believed to originate from neurological damage in brain areas like the cerebellum or thalamus or in the spinal cord that affects movement pathways.
Causes of Tremors in MS
MS is an autoimmune condition that causes the immune system to attack the myelin sheaths protecting nerve fibers in the central nervous system (brain and spinal cord). The resulting lesions disrupt nerve signaling in motor control areas such as the cerebellum and thalamus, leading to abnormal movement control and tremors, especially during voluntary movements.
Management and Treatment
Treatment for MS-related tremors may involve noninvasive procedures such as magnetic resonance-guided ultrasound (MRgFUS) and stereotactic radiosurgery, which can destroy specific brain parts causing tremors.
In some cases, doctors may prescribe medications like beta-blockers (such as propanolol), anticonvulsants (such as gabapentin), isoniazid, clonazepam, and others to reduce MS tremors.
Adapting home, workplace, and daily routines, getting support from an occupational therapist, undergoing physical therapy, and seeking speech or language therapy can also help manage MS tremors.
Long-term Effects and Further Treatments
Deep brain stimulation (DBS) involves implanting electrodes in the brain to deliver electrical pulses and stop severe MS tremors. However, there is not much research on its long-term effects in people with MS.
Botox treatment, which involves injecting Botulinum toxin (Botox) to temporarily paralyze muscles and alleviate tremors, requires repeat injections to control the tremor.
Speech-language therapists can help with speech, communication, swallowing, and language disorders in MS patients. Physical therapists can help improve muscle strength, flexibility, and control, and teach the use of mobility aids.
Conclusion
MS-related tremors primarily arise from lesions in the cerebellum and connected neural pathways, causing intention and cerebellar tremors, as well as internal vibrating sensations distinct from visible shaking. Understanding these tremors is crucial for developing effective management and treatment strategies for people living with MS.
- Treatment seekers living with Multiple Sclerosis (MS) often experience various types of tremors, including intention tremors and cerebellar tremors, both of which are caused by neurological disorders affecting motor control areas.
- Science and medical-conditions, such as MS, have led to the development of several therapies and treatments for managing tremors, including noninvasive procedures, medications, and long-term treatments like deep brain stimulation (DBS) and Botox injections.
- Health and wellness professionals, such as speech-language therapists and physical therapists, play crucial roles in helping MS patients manage their speech, language, and motor disorders, improving their quality of life.
- Significant progress in the understanding of neurological disorders like MS, including the causes of tremors and their manifestations, has enabled the development of more effective treatments and improved the lives of treatment seekers.
