Theories on the Causes of Idiopathic Head Tremors
Not much is as distressing as seeing someone you love show behaviors that seem involuntary and out of the ordinary. Naturally, you want answers, especially if a doctor seems to contradict himself, when he tells you that even though no one knows where a symptom or condition comes from, you do not need to worry about them. Given that you arrived at this article, we understand that you might not be satisfied with this answer. We were in your shoes when Persephone, our Doberman showed idiopathic head tremors as a puppy, for the first time. In this article, we will share what we found while we peppered our integrative vet with question, dug around on the internet, and consulted research databases, and our dog health and wellness library at home. What we want to echo before we begin: We agree with your veterinarian in as so much that you do not need to panic. Get yourself your favorite beverage, get comfortable, give your Doberman a smooch, and delve into some theories about idiopathic head tremors that we hope will give you some perspective to evaluate your situation and make more personalized decisions for your Doberman. A fair warning: many conventional veterinarians will reject some of these theories, but as a blog that tries to avoid dogma, we’d like to offer them to you.
The Question We All Might Have
The idiopathic part of the condition begs the question of how sure a veterinarian can be that the tremors are not part of a greater underlying issue that, when left ignored, may have adverse effects on the dog long-term when the origin of the tremors is deemed unknown? Some veterinarians would likely answer that there is no known or documented collective pattern that would support the greater underlying problem idea behind the question. The issue we have with this response is: idiopathic head tremors are not exactly well studied. “Absence of evidence is not evidence of absence” (sometimes attributed to Carl Sagan and Thomas Sheppard). As such, we would argue that the non-observed pattern is clinical anecdotal evidence or experience-based observation. The lack of empirical evidence, as in not truly studied, should warrant some humility.
A Brief Overview Of The Condition
Idiopathic, by definition, means that the condition arises spontaneously and no known cause is apparent. Idiopathic head tremors are involuntary, rhythmic movements of the head that resemble a "yes" or "no" motion without other neurological symptoms. The episodes, as you may have already noticed in your Doberman, can vary in frequency and duration and they often occur while the dog is at rest. Conventional veterinary medicine’s standpoint, as we have mentioned, is that idiopathic head tremors do neither warrant concern nor treatment. They are also not believed to cause pain or distress to the affected dogs.
Interestingly, about two-thirds of dogs will experience what is deemed a spontaneous improvement in the severity or frequency of their tremor episodes. Sometimes, the episodes may completely resolve over time without any specific treatment. Of course, this natural tendency for improvement offers some reassurance to guardians, who, like us, deal with this condition, but about 1/3 may not improve.
1. Genetic Predisposition
Some experts believe that idiopathic head tremors may have a genetic component. Certain breeds, such as Dobermans, Boxers, Bulldogs, and Labrador Retrievers, are more commonly affected by this condition, suggesting a hereditary link. This theory is supported by the observation that head tremors often occur in specific family lines within these breeds. However, as is usually the case with genetic predisposition, environmental factors may play a gene-activating role.
Moreover, some research suggests that the hereditary link is suspected to play a part when the onset of the idiopathic head tremors occurred before the Doberman’s first birthday. The same research also noted a sporadic form that occurs usually after the dog’s first birthday.
2. Neurological Abnormalities
While some pet owners may be drawn to the theory that their dog’s symptoms are related to seizures, research has shown that they are most likely not related. For one, dogs are alert and mobile during the episodes, and they do not respond to medications that are traditionally given for seizures.
One theory, however, suggests that idiopathic head tremors might be related to underlying neurological abnormalities. These could include issues with neurotransmitter function or structural abnormalities in the brain. While there is no concrete evidence pinpointing a specific neurological cause, the involvement of the central nervous system is a plausible explanation, given the nature of the tremors.
As such, two of the most widely accepted theories in conventional veterinary medicine are that idiopathic head tremors may be related to movement disorders originating in the brain's basal ganglia, which is involved in motor control. The other theory posits that an abnormality in the proprioceptive pathways or the stretch mechanism of the head and neck muscles might be responsible. This theory suggests that when the dog’s attention is diverted during an episode, the head tremors temporarily stop because the neck muscles contract, releasing the stretch mechanism that first provoked the tremors. If you’re part of a Doberman group online, you will often see the recommendation to snap your Doberman out of the head tremors by offering them a treat. We can confirm that when Persephone had her head tremors, they did cease with distraction.
3. Diet and Nutritional Imbalances
Diet and nutrition play a crucial role in a dog's overall health, and imbalances could contribute to head tremors. Deficiencies or excesses in specific nutrients, vitamins, or minerals might affect neurological function and lead to tremors. For example, imbalances in calcium, magnesium, or vitamin B complex can affect muscle and nerve function. In conventional veterinary medicine, any reports that nutritional adjustments have helped alleviate head tremors are usually regarded as anecdotal evidence. Hence, it is usually disregarded as not scientific. While it is true that anecdotal evidence cannot serve as factual evidence that nutritional imbalances are a cause for the tremors, nutritional imbalances nonetheless could influence the frequency and severity of the condition. Interestingly, many of the statements made to support the argument against such theories are based on anecdotal evidence as well. Hence, there is, on both sides, a chance for bias.
4. Immune System Dysfunction
An overactive or dysregulated immune system is another potential cause of idiopathic head tremors. Inflammation of the nervous system or systemic inflammation could trigger tremors. This theory aligns with our experience with Persephone, where her head tremors appeared to be influenced by immune system challenges that might mediate her reactions to vaccinations and dewormers.
5. Environmental Factors and Toxins
Exposure to environmental toxins, such as pesticides, heavy metals, or chemicals, could potentially lead to head tremors. Dogs that come into contact with these substances might experience neurological symptoms as their bodies attempt to detoxify, as a body does naturally (note: we are not fond of the holistic detox craze). This theory is not only particularly relevant for dogs that live in areas with high levels of environmental pollutants but also important in connection with so-called ‘forever chemicals’, also known as PFAS, that are not a fringe idea and can be found in, for example, everyday cleaning products. While most conventionally trained veterinarians, including neurologists, will, in our opinion, correctly remark that tremors caused by toxins will likely not be isolated to the head, there is no definite scientific evidence that idiopathic head tremors are unaffected or worsened by any of these agents. As our integrative vet has stated, in her experience, chemicals found in, for example, dewormers can affect the severity and frequency of idiopathic head tremors. Thus, while they may or may not be causal factors, they, at least, may have the potential to contribute to the condition.
6. Stress and Anxiety
Stress and anxiety are known to have significant impacts on a dog's health, including neurological function. Chronic stress or anxiety could potentially contribute to the development of head tremors. This theory is supported by the observation that some dogs experience tremors more frequently during stressful situations or changes in their environment. It is important to note that we observed significant signs of stress in Persephone when she went through her first two times of deworming. She, unlike our other dogs, was heavily irritable, had a more challenging time than usual to settle and rest, especially at night, and she became much more nippy than otherwise. Thus, the question arises whether the chemicals in the dewormer itself influenced the idiopathic head tremor onset or her being highly stressed from the likely uncomfortable sensations of the deworming. In the end, both variables may have contributed as well. Coincidence may have been at play as well. However, the repeated experience after giving her a usually considered less tolerable dewormer and the stark worsening of the condition after that may speak against coincidence.
7. Gastrointestinal Health
There is a growing understanding of the gut-brain axis, highlighting the connection between gastrointestinal health and neurological function. Since a significant portion of the immune system is located in the gut, any imbalance or dysfunction in the digestive system could impact the nervous system. This theory, in part, resonates with our observations of Persephone's past and sometimes flaring-up gastrointestinal issues and the subsequent improvement in her tremors with dietary and gut health interventions. Then again, correlation does not prove causation. If anything contributed to her head tremors, what’s chicken, what’s egg?
The Importance of Staying Calm
We agree with staying calm and not panicking about the condition. Staying calm is a good idea in two ways. For one, if you stay calm during an episode, your Doberman usually will, as well. Two, a calm mind can make more informed decisions. When you choose to stay calm, you help your dog and yourself.
Thus, the reason we offer these theories is that we want we understand that you may choose to see the tremors as a symptom of something that is not working properly. In our opinion, we agree with you that we wouldn’t see this deviation from the norm if there wasn’t an issue somewhere in the system. However, we provide these theories because they can provide some valuable insights into potential triggers and contributing factors, not to claim that they are what’s causing idiopathic head tremors in Dobermans. It is our hope that these theories can help you, as a dedicated Doberman guardian, develop more effective management strategies of your Doberman’s overall well-being. We think it is, in general, essential to consider a more integrative approach, addressing all aspects of a dog's health, including diet, environment, stress levels, and overall well-being, instead of accepting the often unspoken invitation to just ignore or watch issues.
Don’t Skip The Vet
If your dog is experiencing idiopathic head tremors, consult a knowledgeable veterinarian. Getting a proper diagnosis is crucial. Do not just assume that the head tremors you see are idiopathic head tremors, especially if you see other symptoms. If you don’t want to sit idle with the diagnosis of idiopathic head tremors, consider an appointment with an integrative vet to not only get a diagnosis, but explore potential influences, and develop a tailored plan for managing the condition instead of treating it as a non-event. Of course, we are not trying to suggest that an integrative veterinarian will know the cause of idiopathic head tremors, but at least they may be more inclined not to explore the issue, if your current veterinarian has no suggestions.
Note from the author: Given my, as some call it, unique background, which includes a BS in psychology, radiology, and work in clinical research, I find it important to mention that sometimes people are uncomfortable with the unknown and want to act to, ultimately, avoid feeling helpless. I truly get it. After Sir Francis Drake, our first Doberman, died at 11.5 years old, we collectively swung very far away from conventional veterinary medicine for a while, which can make you more prone to accept whatever sounds reassuring without employing your spidey senses reliably. Ultimately, we arrived at what I call the middle-ground paired with scientific skepticism. As such, my recommendation is that exploring theories and testing out some things, such as diet changes, removing environmental toxins, and individualizing medications and vaccinations in collaboration with a veterinarian, is within the limits of thoughtful guardianship. However, make sure you’re predominantly doing it for your Doberman with common sense and not to calm yourself, because when the tremors do not resolve, you may become prone to going down the rabbit hole of the pseudoscientific internet, and it’s sometimes outright dangerous advice. Always remember, it is impossible to draw conclusions about causes from anecdotal evidence. As explained, idiopathic head tremors may improve or resolve on their own.
Disclaimer: The information provided in this article is for educational and informational purposes only and is not intended as a substitute for advice from your veterinarian or other healthcare professional. You should not use this information to diagnose or treat a health problem or disease or prescribe any medication or other treatment. Always consult with your veterinarian or other qualified healthcare provider before making any changes to your pet's healthcare regimen, especially if they have or suspect they may have a health problem. The author and publisher of this article are not responsible for any adverse effects or consequences resulting from the use of any suggestions, products, or procedures mentioned in this article. The use of this information is at the reader's discretion and risk.
Further Reading:
Here are a few scientific articles and sources that you can refer to for more detailed information on idiopathic head tremors in dogs:
1) Imepitoin for treatment of idiopathic head tremor syndrome in dogs: A randomized, blinded, placebo-controlled study:
https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15955
2) Clinical and Breed Characteristics of Idiopathic Head Tremor Syndrome in 291 Dogs: A Retrospective Study:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4430662/
3) An inherited episodic head tremor syndrome in Doberman pinscher dogs:
https://movementdisorders.onlinelibrary.wiley.com/doi/abs/10.1002/mds.23936
4) Idiopathic and structural episodic nonintentional head tremor in dogs: 100 cases (2004‐2022):
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658580/
5) Imepitoin for treatment of idiopathic head tremor syndrome in dogs: A randomized, blinded, placebo‐controlled study:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7694850/
