Tremors as a Symptom of Multiple Sclerosis

Tremors are one of the most common symptoms of multiple sclerosis

Multiple Sclerosis, Consultation. Credit: BSIP / Contributor / Getty Images

Tremors are a very common symptom of multiple sclerosis (MS). They can occur when a person is trying to do something with their hands or when standing or sitting, and severity can range from barely noticeable to significantly interfering with daily tasks.

What Does it Feel Like?

Tremors are involuntary muscular contractions that result in a rhythmic back-and-forth movement of a specific body part. While the hands are usually affected, tremor also can affect legs, the vocal cords, head, and trunk.

There are two types of tremor in MS:

  • Intention Tremor: This is the kind of tremor that occurs when you reach for something and your hand starts shaking. The closer you get to your target or the smaller the movement required, the more your hand or arm will shake. This is the most common type of tremor.
  • Postural Tremor: This is a shaking that occurs while you are sitting or standing and your muscles are trying to hold parts of your body still against the force of gravity.

Although postural and intention tremor are by far the most common, some people experience tremor of the jaw, lip or tongue which may affect their ability to speak clearly. Also, nystagmus (“jiggling eyes”) is also considered a form of tremor by some.

Also, you should not experience either intention tremor or postural tremor when you are asleep or even just lying down and the muscles are relaxed. If you have a tremor while you are resting, this may be the result of something else, like a drug side effect, and you should mention it to your doctor.

What Causes Tremor in MS?

Most MS tremors are caused by demyelination to the cerebellum or the nerves leading to or away from it. The cerebellum is the part of the brain which controls balance and coordination, and it helps makes movements of the limbs, mouth and eyes smooth and fluid.

Tremor can also be the result of demyelination in the thalamus, which is the part of the brain that controls the motor systems in the body, and the basal ganglia, which are located on either side of the thalamus in the brain.

How Common is Tremor in MS?

It is estimated that up to 75 percent of people with MS experience tremor at some point. However, nearly 50 percent of patients on the North American Research Committee on MS (NARCOMS) registry report suffering from tumors of differing severity, according to a report on the subject published in a 2015 issue of the British Medical Journal.

Usually, tremor develops after people have had MS for at least five years, though this isn't a fast hard rule. Tremor can occur as a relapse symptom and disappear on its own or after a course of corticosteroids, however, it is common for residual tremor to remain.

How Severe Can it Get?

For the majority of people, tremor is simply annoying and can be embarrassing. However, a tiny percent of people may experience tremor so severe that it becomes impossible to perform necessary tasks like eating, drinking or getting dressed.


Multiple Sclerosis Society UK. Tremor.

The Multiple Sclerosis Resource Centre. Tremor.

Rinker JR 2nd, Salter AR, Walker H, Amara A, Meador W, Cutter GR. Prevalence and characteristics of tremor in the NARCOMS multiple sclerosis registry: a cross-sectional survey. BMJ Open. 2015 Jan 8;5(1):e006714. doi: 10.1136/bmjopen-2014-006714.

Continue Reading