July 11, 2019

expert reaction to reports of Angela Merkel shaking

Experts comment on German Chancellor Angela Merkel being seen shaking at an official event for the third time.

Prof K Ray Chaudhuri, Professor of Movement Disorders and Neurology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said:

“There are many causes of ‘shaking’ or tremor, and body shaking can be indeed precipitated by severe stress, anxiety or low blood sugar.  Temperature changes (severe cold or heat) may also precipitate short lasting ‘shaking’ episodes.  In some individuals there are rare causes such as orthostatic tremor (tremor that occurs when someone is upright) – but that is usually seen in the legs only.  30% of people with Parkinson’s do not have a tremor, and those who do show a very different pattern of tremor known as resting tremor.”

Prof Peter Roberts, Emeritus Professor of Pharmacology, School of Physiology, Pharmacology & Neuroscience, University of Bristol, said:

“There is little information available beyond what has been stated by Angela Merkel, so it’s impossible to know what might be the cause.  An initial effect caused by dehydration followed by anxiety that it may occur again, might even be the cause.  The stress response is a basic survival mechanism (fight or flight) and kicks in as soon as a threat is perceived, including fear that something may happen, e.g. uncontrollable shaking.

“I recall, in my younger days, climbing in Scotland and becoming temporarily stuck – this provoked fear (involving the amygdala) followed by the stress response and intense shaking.  The only way to overcome this was to relax, breathe and think beyond the stress trigger.  I remember it took me a good 10 minutes or so before my limbs were steady.

“In the absence of any underlying pathology, this is a likely cause – i.e. it could be based on the science of the wholly normal stress response.  The problem with the response is that our bodies behave in this way in response to both real and feared threats; indeed the fear that your body is going to start behaving in a seemingly abnormal way may precipitate that very response.

“Merkel’s own comment that she feels very well would be consistent with a stress response that passes when the situation associated with its initiation passes.  It is perhaps significant that these episodes have occurred under very similar circumstances.”

Declared interests

None received.