Shaking or tremors after a head injury can be alarming and disruptive. For many individuals, these involuntary movements significantly impact daily life, causing physical discomfort and emotional distress. 

Whether the tremors occur immediately after the injury or develop over time, understanding the underlying causes, symptoms, and available treatments is essential for managing this condition effectively.

In this blog post, we'll explore post-traumatic tremors in detail, breaking down the causes, types, and potential treatment options. By shedding light on this condition, we hope to empower those affected with knowledge and hope for recovery.

What causes post-traumatic tremors?

Post-traumatic tremors are involuntary, rhythmic muscle movements that often arise after traumatic brain injuries (TBI). These tremors occur due to damage to specific parts of the brain, particularly those involved in motor control, such as the cerebellum, basal ganglia, or thalamus.

Head injuries can disrupt neural pathways that send precise signals to the muscles, leading to uncoordinated or excessive movements. Common causes of post-traumatic tremors include:

• Direct brain trauma: Injuries that physically damage motor-control regions of the brain.
• Swelling or bleeding: Hematomas or edema can exert pressure on neural structures, impairing motor function.
• Neurochemical imbalances: Alterations in neurotransmitters can affect muscle control.
• Post-concussion syndrome: Even mild injuries like concussions can result in long-term neurological changes leading to tremors.

Individuals with severe TBIs or those who experience multiple head injuries may be at higher risk of developing tremors. Additionally, a history of neurological conditions such as Parkinson's disease can exacerbate symptoms.

What are the symptoms of post-traumatic tremors?

Post-traumatic tremors are characterized by rhythmic shaking or involuntary movements in various parts of the body. Symptoms can vary depending on the severity and location of the brain injury.

• Shaking of the hands, arms, or legs
• Head tremors or neck movements
• Trembling voice
• Difficulty performing fine motor tasks such as writing or buttoning clothes
• Increased severity during stress or fatigue

Some individuals may also experience secondary symptoms like muscle stiffness, balance issues, or coordination problems, which can further impact daily activities.

What are the different types of tremors after a head injury?

Post-traumatic tremors can manifest in different ways depending on the affected brain region. 

The most common types include:

1. Resting tremor

This type occurs when the body is at rest and muscles are relaxed. Resting tremors often involve the hands or fingers and can be a sign of damaged basal ganglia.

2. Action tremor

Action tremors happen during voluntary movements, such as reaching for an object or writing. Subtypes of action tremors include:

• Postural tremor: Appears when maintaining a specific posture.
• Intention tremor: Occurs during targeted movements, becoming more pronounced as the individual nears their goal.

3. Essential tremor-like movements

Some head injuries can mimic the symptoms of essential tremor, a common movement disorder unrelated to trauma.

4. Cerebellar tremor

This is often slow and intentional, resulting from cerebellar damage. It can affect balance and coordination.

Other movement disorders that cause shaking after head injury

Tremors are just one of many potential movement disorders following a TBI. Other conditions that might cause shaking include:

• Myoclonus: This condition involves sudden, jerky movements rather than rhythmic shaking. It can affect any muscle group and may occur unpredictably.
• Dystonia: Dystonia causes sustained muscle contractions leading to abnormal postures or twisting movements, which can sometimes appear as tremors.
• Spasticity: Increased muscle stiffness or spasms, common after brain injuries, can result in tremor-like movements when attempting to move.
• Parkinsonism: Head trauma may lead to Parkinsonian symptoms like bradykinesia (slowed movements) and rigidity, alongside tremors.

These disorders often overlap, making precise diagnosis crucial for effective treatment.

How are post-traumatic tremors diagnosed?

A comprehensive evaluation is necessary to identify the type and cause of post-traumatic tremors. Diagnosis typically involves:

• Detailed medical history: Doctors will ask about the nature of the head injury, onset of symptoms, and any previous neurological conditions.

• Physical and neurological examination: A thorough assessment of motor function, coordination, and reflexes helps pinpoint affected areas of the brain.
• Imaging studies: MRI or CT scans can reveal structural damage or bleeding in the brain. Functional imaging, like PET scans may be used to observe brain activity.
• Electromyography (EMG): This test measures electrical activity in muscles to evaluate tremor patterns and severity.

How to treat tremors after a brain injury?

Treatment for post-traumatic tremors often requires a multifaceted approach, including medication, therapy, and sometimes surgery.

Medications

Medications are often the first line of treatment and can help reduce the severity and frequency of tremors. Some examples include

• Beta-blockers (e.g., propranolol): Commonly used for action tremors or essential tremor-like symptoms.
• Anticonvulsants (e.g., primidone): Help control rhythmic muscle activity.
• Benzodiazepines (e.g., clonazepam): May reduce tremors caused by anxiety or overstimulation.
• Dopaminergic agents (e.g., levodopa): Prescribed if the tremors have Parkinsonism-like characteristics.
• Botulinum toxin injections: These injections relax overactive muscles and temporarily relieve localized tremors, such as those in the hands, neck, or vocal cords.

Physical and occupational therapy

Rehabilitation plays a crucial role in improving motor function and quality of life. Therapists will help patients adapt to tremors through the following:

• Strengthening and coordination exercises: Help rebuild muscle control and minimize tremors during intentional movements.
• Assistive devices: Tools like weighted utensils, writing aids, or braces can reduce the impact of tremors on daily tasks.
• Balance training: Particularly beneficial if tremors affect posture or gait.

Psychotherapy or behavioral interventions

For tremors exacerbated by stress, anxiety, or fatigue, the following types of therapies can help.

• Cognitive behavioral therapy (CBT): Teaches relaxation techniques to manage stress-related triggers.
• Mindfulness and biofeedback: Help patients gain better control over involuntary movements.

Surgical interventions

When other treatments are ineffective, surgical options may be considered:

• Deep brain stimulation (DBS)

• Electrodes are implanted in the brain to send electrical impulses to specific motor regions, helping to regulate abnormal signals.
• It is particularly effective for severe tremors that don't respond to medications.
• Thalamotomy
• A less common procedure where a small part of the thalamus is surgically destroyed to alleviate tremors.

Lifestyle adjustments and supportive measures

Doctors often recommend lifestyle changes to complement medical treatment. Some examples include the following:

• Stress reduction: Incorporate yoga, meditation, or mindfulness exercises.
• Caffeine and alcohol reduction: Both can worsen tremors in some individuals.
• Consistent sleep schedule: Improves overall neurological function and reduces fatigue-related tremors.

Experience Hope and Healing at NeuLife Rehabilitation

Recovering from post-traumatic tremors and other effects of a traumatic brain injury requires more than just medical care—it demands a comprehensive approach that addresses both physical and emotional well-being. 

At NeuLife Rehabilitation, we specialize in providing the post-acute therapies and support necessary to help individuals regain independence and improve their quality of life.

Our post acute rehabilitation offers care tailored to those living with TBI, spinal injuries, amputations, severe orthopedic conditions, strokes, or neurological disorders. We provide 24/7 care, ensuring that each resident receives the dedicated attention and expert treatment they need.

Contact our neuro rehab today or visit our traumatic brain injury rehabilitation facility. 

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.