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Posted February. 27, 2006 03:00,   


People often suffer from all types of body tremors. When those symptoms appear out of the blue, people start to worry whether something is wrong with their brain. As they become more concerned, so does the trembling.

Sinchon Severance Hospital Neurology Professor Kim Seung-min says, “Eye trembling generally occurs when under serious fatigue or when working with the computer or watching TV for long periods. It is a warning from the body, signaling fatigued eye muscles, and calls for rest.”

Trembling All Over—

Trembling can also occur in hands, feet and facial areas. There are people whose hands shake while pouring a drink or while using spoons. These are called “hand tremors,” and according to a recent American epidemiological survey, 96 out of 100 people show symptoms.

Facial cramps that occur over half of the face can also cause trembling. Cramps can start in the eye area, and as they become more serious, the eyes will shut and the mouth will contract upwards. In medical jargon this is known as a hemifacial spasm.

Why do They Occur?—

Nerves control all muscles that shake or tremble. The cranial nerves order the muscles to contract, and responding to such orders, the muscles contract, causing trembling.

Physiologically, muscles engage in minute repetitive movements that the naked eye cannot perceive. In order to prevent severe trembling, there is a motor control center in the brain that controls the movement of muscles. If for any outside reason, such as motor center function damage, the nerves become stimulated, they can become uncontrollable, leading to trembling.

Samsung Seoul Hospital Neurologist Lee Won-yong says, “Hand trembling often affects those in their 20s through 60s, and about 60 percent of the cases are hereditary. In particular, trembling might occur after intensive exercise, psychological stress, cold weather, or during a fever.”

Shaking in the hands and feet is also a symptom of disorders such as Parkinson’s Disease, hyperthyroidism (over activity of the thyroid), or when there is a problem with the parathyroid gland. In addition, taking certain drugs such as bronchus medicine, caffeine-containing drugs, and anti-depressants might also result in hand trembling.

Treatment and Preventive Measures—

The majority of simple eyelid trembling cases are caused by stress, so one or two days of rest will usually bring good results. It will also help to apply an ice pack over the trembling area. Furthermore, caffeinated beverages and foods that stimulate nerves and cause contractions in muscles should be avoided. If the trembling symptoms do not improve, doctors will prescribe tranquilizers or anti-epileptic drugs. Generally, a week or two of drug treatments will improve one’s symptoms.

If the trembling does not improve with these measures, a patient should look for the cause of the trembling carefully, examine what types of drugs are being taken, and examine one’s own disorders, such as hyperthyroidism. In some cases, brain tumors might cause eyelid trembling, but this is rare.

If drug therapy does not work, botox is used. Botox paralyses the stimulated muscle nerves and halts the contraction of muscles. Although results last for about three months, one will have to take another botox treatment to maintain the effect. In cases of severe hand trembling, blockers that suppress tremors are also quite effective.

On the other hand, hemifacial spasms are excessive reactions of facial nerves stimulated by the cerebral artery, so botox is ineffective. In most cases, they require neurosurgery.

Jin-Han Lee likeday@donga.com