Tremors as a Symptom of Multiple Sclerosis

One of the most common symptoms of multiple sclerosis

Old hands help

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Tremors, or shaking that a person cannot control, are a common symptom of multiple sclerosis (MS). They can occur when a person is trying to do something with their hands or when standing or sitting. Tremor severity can range from barely noticeable to significantly interfering with daily tasks.

How Common Is Tremor in MS?

According to a report in British Medical Journal, approximately 50 percent of people with multiple sclerosis experience tremor, with about 5 percent reporting severe tremor. The severity of tremor is not linked to how long a person has had MS.

Usually, tremor develops after people have had MS for at least five years, though this isn't a hard and fast rule. Tremor can occur as a relapse symptom and disappear on its own or after a course of corticosteroids. However, it is also common for a residual tremor to remain.


Most MS tremors are caused by demyelination to the cerebellum or the nerves leading to or away from it. The cerebellum is the part of the brain which controls balance and coordination, and it helps makes movements of the limbs, mouth, and eyes smooth and fluid.

Tremor can also be the result of demyelination in the thalamus, which is the part of the brain that controls the motor systems in the body, and the basal ganglia, which are located on either side of the thalamus in the brain.

Signs and Symptoms

Tremors are involuntary muscular contractions that result in a rhythmic back-and-forth movement of a specific body part. While the hands are usually affected, tremor also can affect legs, the vocal cords, head, and trunk.

There are two types of tremor in MS:

  • Intention Tremor: This is the kind of tremor that occurs when you reach for something and your hand starts shaking. The closer you get to your target or the smaller the movement required, the more your hand or arm will shake. This is the most common type of tremor.
  • Postural Tremor: This is a shaking that occurs while you are sitting or standing and your muscles are trying to hold parts of your body still against the force of gravity.

Although postural and intention tremor are by far the most common, some people experience tremor of the jaw, lip, or tongue which may affect their ability to speak clearly.

It's important to note that you should not experience either intention tremor or postural tremor when you are asleep or even just lying down and the muscles are relaxed. If you have a tremor while you are resting, this may be the result of something else and you should mention it to your doctor.

For the majority of people, tremor is simply annoying and can be embarrassing. However, a tiny percent of people may experience tremor so severe that it becomes impossible to perform necessary tasks like eating, drinking, or getting dressed.


The good news is that there are a number of medications available to help you manage your tremor. Although, it's often a trial and error process to see which one works for you. Sometimes, people with tremor benefit from additional therapies like occupational therapy or seeing a psychologist or therapist to cope with the psychological implications of having a tremor.

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