Tremorsexperienced by people withmultiple sclerosis (MS)are often characterized by:

  • a shaky voice
  • 一种有节奏的震动，影响胳膊和手，而不是常见的腿，头和躯干
  • difficulty holding or controlling a pen, spoon, or other tool or utensil

A 2020点评 estimates that tremor affects between 25 to 58 percent of people with MS. There are different types of MS tremors, such as action tremors and resting tremors.

Hand tremors can be classified as an intention tremor, dystonic tremor, or an essential tremor. Hand tremors caused by MS may be mistaken for Parkinson’s Disease tremors. A person with MS may experience a hand tremor when reaching for something. Hand tremors can occur at rest as well.

Tremors from MSmay look喜欢摇晃，颤抖，抖动或抽搐。当一个人使用它时，意图震颤会导致受影响的肢体中的不受欢迎的运动，例如到达杯子。当一个人保持一定的姿势时，姿势震颤会导致不必要的运动，例如坐在何时。

For people with MS, tremors are usually caused by brain lesions (specifically in thecerebellum) and damaged areas — called plaques — along the nerve pathways that are involved with coordinating movement.

The same plaques sometimes also result in other symptoms such asdysphagia(difficulty swallowing) or dysarthria (difficulty speaking).

Tremors can get worse over time and be more difficult to manage if a person already has poor eyesight or numbness in the body. A person with MS may trigger tremors with caffeine or anxiety.

A person with MSmay experiencean increase in the intensity of their tremors after vigorous exercise. However, muscle tremors after exercising are common for people who do not have MS. Muscle shaking after exercise can occur due to muscle fatigue, low blood sugar, or dehydration.

A person with MS may experience more tremors at night if they have a resting tremor. This type of tremor occurs most often when a person is sitting still versus moving. However, resting tremors are more common in Parkinson’s disease than MS.

There are two primary types of tremor: resting and action.

Resting tremor

Resting tremor occurs when there is shaking even when a body part is at rest. For example, a person may be sitting comfortably with their hands resting in their lap, but their fingers shake.

Action tremor

Action tremor occurs when a muscle is being voluntarily moved. For example, a person may be reaching to pick up a glass of water and their hand starts to shake.

There are a number of subclassifications of action tremor, including:

  • Intention tremor.These are associated with physical movement. There is no shaking when a person is at rest, but a tremor develops and becomes more pronounced as they attempt to make a precise movement such as shifting a foot or hand to a specific spot.
  • Postural tremor.These are associated with moving or supporting against gravity, such as a tremor that develops while standing or sitting, but not while lying down.
  • Nystagmus.These tremors are associated with jumpy eye movements.

For people with MS, the most common forms of tremor are intention tremor and postural tremor.

Currently, there is no cure for tremors. But there are ways for people with MS to reduce their occurrence and improve function.

Lifestyle changes

The following lifestyle changes may help decrease the occurrence of tremors:

  • 避免压力
  • getting enough rest
  • avoiding caffeinated drinks

Physical and occupational therapy

Physical and occupational therapists can help people with MS control tremors by:

  • teaching exercises for coordination and balance
  • recommending stabilizing braces in certain cases
  • 展示如何使用权重来弥补震颤
  • 教学新的方式表演MS震颤的日常活动可能会挑战

Medication

A consistently effective drug for tremors hasn’t yet been identified. According to theNational Multiple Sclerosis Society, however, health professionals have reported varying degrees of success in treating tremors in people with MS using drugs including:

  • beta-blockers, such aspropranolol(Inderal)
  • anti-anxiety medications, such asbuspirone(Buspar) andclonazepam(Klonopin)
  • anticonvulsive drugs, such asprimidone(Mysoline)
  • antituberculosis medication, such as isoniazid
  • antihistamines, such as hydroxyzine hydrochloride (Atarax) and hydroxyzine pamoate (Vistaril)
  • 乙酰唑胺（Diamox）等利尿剂

Natural remedies

MS can be treated but not cured. There are some natural remedies that may complement other MS treatments and help relieve symptoms. These include :

These natural remedies for MS may help with symptoms such as inflammation, anxiety, difficulty sleep, and pain.

Botox

A 2012 study indicated that the sameBotox(botulinum toxin type A) injections used to temporarily smooth facial lines significantly improved arm tremor in people with MS.

Surgery

People with MS who have severe disabling tremors despite medications may be good candidates for surgical treatment.

There are two types of surgery that may help tremors in people with MS: thalamotomy and deep brain stimulation.

Thalamotomy是一种摧毁丘脑部分的手术，大脑中的一个有助于控制运动的结构。

Deep brain stimulation implants a tiny electrode into the thalamus. The electrode is then attached to a wire that connects to a device under the skin in the chest area. The device delivers small electrical impulses to the thalamus.

Deep brain stimulation isn’t approved by the U.S. Food and Drug Administration (FDA) for treatment of MS-related tremor. However, it has been used successfully for this purpose, and for other conditions that cause tremors, such as Parkinson’s Disease.

The MS tremors that develop for some people can be mild or severe and disabling.

While there is no cure for tremors yet, people with MS have ways to reduce the occurrence of tremors and improve function including physical and occupational therapy, medication, and lifestyle changes.

A person may want to see their doctor if they experience tremors for the first time, or if their tremors get worse or drastically change.