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Cerebral Palsy and Tremors: Managing Involuntary Shaking

cerebral palsy tremors management

Wondering what causes tremors in individuals with cerebral palsy?

tremor is an “an involuntary, rhythmic, and oscillatory movement” that can occur in any area of your body.

In cerebral palsy patients, tremors are generally caused by damage to the developing brain.

This article will explore what type of cerebral palsy is most commonly associated with tremors and how to manage them.

Cerebral Palsy and Tremors

Tremors are most commonly associated with ataxic cerebral palsy. This is the least common type of CP, making up about 5% of all cases.

It is caused by damage to the part of the brain called the cerebellum, which is responsible for balance and coordination skills.

Individuals with ataxic cerebral palsy experience intention tremors. This is a type of action tremor that occurs when you try purposefully to move from one point to another.  

Intention tremors worsen as you get closer to your target. They make it difficult to perform tasks that require fine motor skills like writing and using silverware.

Depending on the location of cerebellum damage, intention tremors can occur in one or both sides of the body. Damage to the right side of the cerebellum can cause tremors in the left side of the body and vice versa.

Co-Occurring Symptoms

Other symptoms associated with cerebellum damage that can co-occur alongside tremors include:

  • Gait abnormalities (typically a wide-based gait)
  • Poor coordination and balance
  • Dizziness
  • Fine motor problems
  • Low muscle tone
  • Speech difficulties

Keep in mind that everyone experiences ataxic cerebral palsy differently.

Depending on the severity of damage to the brain, symptoms will vary.

Managing Cerebral Palsy and Tremors

how to treat cerebral palsy tremors


Fortunately, the brain damage that causes cerebral palsy will not worsen over time.

However, if left unmanaged, symptoms can progress and significantly affect an individual’s quality of life.

Some of the best ways to manage tremors include:

Physical Therapy

Physical therapy will help individuals with ataxic cerebral palsy improve their gross motor functions through balance and coordination exercises.

Tremors can make it challenging to move, which can discourage people with cerebral palsy from attempting movements that require coordination. Gross motor coordination problems can cause difficulties not only with walking, but also with the motions required for many outdoor activities and games, including jumping, skipping, throwing and kicking.

If you don’t practice using your coordination skills, they cannot improve. Therefore, physical therapy for tremors will focus on massed practice of appropriately challenging coordination tasks.

While tremors may not go away, the continuous stimulation can help individuals get more comfortable moving around and working with their tremors.  

Occupational Therapy

At occupational therapy, patients with tremors will learn how to improve their mobility by practicing activities of daily living.

Consistently practicing activities of daily living like getting dressed, brushing your teeth, and using silverware can help individuals with ataxia develop their fine motor skills.

An occupational therapist may also teach you how to use adaptive equipment like reachers, adaptive utensils, and button hooks to be more independent.


Unfortunately, a long-term pharmacological treatment for intention tremors has yet to be established.

While medications can help reduce the severity of tremors, they are not recommended for long-term use due to potentially harmful side effects.

Common medications used to treat tremors in cerebral palsy patients include:

  • Beta-blockers (Propranolol)
  • Anti-convulsants (Carbamazepine, Clonazepam, Gabapentin, Levetiracetam, Primidone, Topiramate)
  • Dopamine Promoters (Ropinirole, Amantadine, Levodopa, Pramipexole)
  • Benzodiazepines (Diazepam, Alprazolam, Clonazepam)
  • Botox Injections

Make sure that your child’s doctor is aware of all other medications your child is taking. Some medications do not react well when taken together.

Tremors in Cerebral Palsy Patients: Key Points

While tremors are most common in individuals with ataxic CP, those with other types of CP can also experience them.

Many people with mild tremors learn how to effectively manage and prevent them from significantly interfering with their everyday lives.

With repetitive practice, individuals can learn to work with their tremors and improve their mobility.

Hopefully, this article helped you better understand why some cerebral palsy patients experience tremors and how to manage them. Good luck!

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You’re on a Roll: Discover a home exercise program for CP that’s actually fun to do!

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Music is a motivator for him. He has been using it on his arm and we will try the leg exercises soon.”

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