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Senior Correspondent


Q: I heard that Botox can help if you have shaky hands. Is that true? 

A: Yes, it’s true that Botox is used to treat hand tremors. Injections can bring relief for as long as three months.

Botulinum toxin type A (Botox) injections, popularly used for ironing wrinkles, are used to treat muscle spasms and tremors caused by diseases like multiple sclerosis or neurological conditions causing muscle spasms of the neck, shoulders and face.

Shaky hands are a symptom of essential tremor (ET), the most common movement disorder. Abnormal communication within the brain causes ET. There is no cure yet for this disorder.

The medical community calls it “essential” because it isn’t linked to other diseases.

ET is often confused with Parkinson's disease. Parkinson's is associated with a stooped posture, slow movement, a shuffling gait and other difficulties. Unlike Parkinson's disease, however, ET doesn't lead to serious complications.

However, not all tremors are caused by ET. There are more than 20 kinds of tremors. For instance, excessive caffeine, alcohol withdrawal, problems with thyroid or copper metabolism or the use of certain medications may also cause tremors.

A genetic mutation is responsible for about half of all ET cases. The only other known risk factor is old age. Although ET can affect people of all ages, it usually appears in middle age or later. Men and women are affected equally.

Tremor is an involuntary movement of one or more parts of the body. Most tremors occur in the hands. Tremors can also show up in the arms, head, face, vocal cords, trunk, and legs.

Victims of tremors usually get them when they make a delicate movement such as writing with a pen or tying shoelaces. Tremors usually disappear when a person is resting.

Some people have relatively mild tremors throughout their lives, but others develop more severe tremors and increased difficulty in movements.

Most people with ET don't need treatment. The effects of the condition can be eased by avoiding what aggravates the problem — lack of sufficient sleep, anxiety, stimulants such as caffeine and extreme temperatures.

Drinking alcohol can calm tremors for up to an hour after consumption. However, tremors tend to worsen when the alcohol wears off.

Physical therapy and exercise can develop more stability in people with ET.

There are other medications besides Botox that can bring relief. These include beta blockers normally used to treat high blood pressure, anti-seizure medications and tranquilizers.

If tremors are severe and drugs don’t help, there are surgical procedures available.

Thalamotomy is a procedure that involves making a small hole in a part of the brain called the thalamus. The surgery destroys the faulty circuit or brain cells that modulate tremor.

An alternative to thalamotomy is thalamic stimulation. An electrode connected to a stimulation device, is placed in the center of the brain. The stimulator is placed under the skin below the collarbone. Electrical currents sent through the electrode interrupt communication between tremor cells. This process reduces tremors within seconds.

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