From the Research
Intention tremors are primarily caused by damage to the cerebellum or its connecting pathways in the brain, as evidenced by the most recent study in 2019 1. These tremors occur during voluntary movement and worsen as the person approaches a target, making precise movements difficult. Common causes include:
- Multiple sclerosis
- Stroke
- Traumatic brain injury
- Alcohol use disorder
- Certain medications
- Brain tumors
- Neurodegenerative diseases like cerebellar ataxia The cerebellum normally coordinates smooth, precise movements by comparing intended actions with actual movements and making adjustments. When damaged, this coordination system fails, resulting in overshooting movements and tremors. Unlike resting tremors seen in Parkinson's disease, intention tremors are absent at rest and appear specifically during purposeful actions. Diagnosis typically involves neurological examination, imaging studies like MRI, and sometimes blood tests to identify the underlying cause. Treatment focuses on addressing the primary condition rather than the tremor itself, though medications like propranolol, primidone, or topiramate may help reduce tremor severity in some cases, as supported by earlier studies 2, 3, 4, 5. It's essential to note that the clinical phenomenology of tremor of cerebellar origin is heterogeneous and extends beyond intention tremor, including postural tremors, kinetic tremor, rest tremor, and orthostatic tremor, as highlighted in the 2019 study 1.