What Is an Intention Tremor: Causes and Treatment

An intention tremor describes an involuntary type of trembling. This condition intensifies as you make a deliberate movement toward an object. Other debilitating symptoms may accompany the tremor, impacting posture, balance, and motor coordination. An intention tremor can feel alarming, especially if it's your first experience.

Intention tremors occur due to cerebellar dysfunction. It affects coordinated movements of the limbs or muscles. This condition has similarities to rubral, cerebellar, and course tremors, so there may be overlaps in the symptoms. You should consult a medical professional for a comprehensive diagnosis. In addition, you may follow up with a chiropractor for ongoing treatments.

This guide covers more information about intention tremors, their causes, and possible treatment solutions.

What is an intention tremor?

An intention tremor is an involuntary trembling that worsens as you move toward an item. It can occur in various body parts, but roughly three-quarters happen in the arms or legs. Another place you are likely to see intention tremors is in the hands. Intention tremors cause problems with coordinating the eye to an object. Typically, you may experience this condition when drinking from a cup or grabbing utensils to eat.

You should seek a medical diagnosis if intention tremors become a debilitating issue. In a third of patients, intention tremors may come with essential tremors, compounding the problem. A professional can determine whether the intention tremor comes from a life-threatening ailment, such as ischemic strokes or malignancy. Many intention tremors are not life-threatening. Nonetheless, this frustration condition may impair daily living and worsen if left untreated.

Intention tremor causes

Identifying the cause of intention tremors is a crucial step before treatment. This condition shares similar, overlapping symptoms as other tremors. As such, an extensive evaluation will help determine if a specific patient has intention tremor. Multiple sclerosis (MS) and strokes are typically the two common causes of intention tremors.

Multiple Sclerosis (MS)

The most common cause of intention tremors is multiple sclerosis, or MS. MS tremors are often intention tremors. They do not occur when a person is at rest, only during movement. The tremor will worsen as someone tries to reach for something or complete an activity, such as moving their foot to a designated spot.

Strokes

In addition, intention tremors can develop for the first time following a stroke. It originates from the cerebellum, a small structure behind the brainstem. The cerebellum controls voluntary movement, posture, and balance. Unfortunately, a stroke can impact the cerebellum and its mechanisms, impairing the central nervous system. As a result, it causes an intention tremor.

Other causes

Intention tremors can also occur from several other causes outside of neuroinflammatory or autoimmune disorders. For example, the condition may occur due to anti-epileptic medications, such as phenytoin or carbamazepine. Similarly, it may stem from extreme physiological or psychiatric symptoms like anxiety, anger, fear, or fatigue. Here are other common causes of intention tremors:

• Hereditary conditions, such as Wilson disease.
• Cerebellar infarcts, or similar vascular causes.
• Diffuse axonal injuries or similar traumas.
• Hepatocerebral degeneration or similar metabolic conditions.
• Toxicity from barbiturate overdose, alcohol dependence, or mercury poisoning.

Intention tremor test

The intention tremor test begins with an MRI, which evaluates the state of the brain and cerebellum. The medical expert will also analyze psychiatric history and stress levels. Additionally, they will thoroughly review home medications that could cause intention tremors.

You may undergo other intention tremor testing methods, such as:

Body testing

The expert will evaluate the body for trauma through blood testing, CT scans, brain MRIs, electromyography, or nerve conduction tests.

Metabolic testing

The expert will conduct metabolic testing to determine if there is a vitamin deficiency, liver function issues, or related problems.

Toxicity testing

The expert will perform toxicity testing through urine toxicology analyses.

Stroke testing

The expert may order a comprehensive stroke workup, including blood panels, CT scans, echocardiogram, and other tests.

Extensive testing

Often, a comprehensive evaluation may be necessary. The expert will analyze neuroinflammatory, autoimmune, and paraneoplastic factors. The results may identify multiple sclerosis, lupus, or other disorders.

Intention tremor treatment

In most cases, intention tremor symptoms can improve gradually through physical rehabilitation. These treatments target the root cause, controlling the condition to a degree. Unfortunately, some patients may experience permanent damage to the cerebellar structure or tracts, causing irreversible intentional tremors.

Treating an intention tremor involves addressing the underlying disorder and cause. There are no medications to take for intention tremors. However, the medical professional may propose various pharmacological solutions, including isoniazid, botulinum toxin A, and cannabis. Several non-invasive techniques also exist based on physiotherapy. The intention tremor treatment plan may involve gait rehabilitation, tendon vibration, positioning techniques, weighting extremities, and manual manipulation.