The usual causes of involuntary head shaking in the elderly include: idiopathic tremor, Parkinson’s disease, brain diseases, and adverse drug reactions. 1. Idiopathic tremor: the cause is unknown, and there is a family history of the disease. The main symptom is involuntary shaking of hands and head. Symptoms may be aggravated when attention is focused and mental tension is high. Most of the patients progress slowly, generally do not need special treatment, but when the condition is serious, you can follow the doctor’s instructions to take Metoprolol and other drugs for treatment. 2. Parkinson’s disease: not only will it cause the elderly to experience involuntary head shaking, but it will also cause dystonia, involuntary hand shaking, slow movement, and difficulty in maintaining postural balance, etc. It is associated with genetic factors, environmental factors, and neurological factors. It is related to genetic factors, environmental factors and nerve aging. 3. Brain diseases: When the cerebral blood vessels and brain nerves are damaged, it will also be manifested in the phenomenon of involuntary head shaking. CT or MRI of the skull can be done for accurate diagnosis, to find a clear lesion and intervene as early as possible. 4. Drug side effects: If the elderly take some antipsychotics, such as chlorpromazine, Sulpiride, Phenazopyridine, etc., it may induce a series of extrapyramidal adverse reactions, resulting in involuntary head shaking. In summary, the elderly head involuntary shaking can be caused by many reasons, it is recommended to go to the regular hospital in time to identify the causes, and targeted treatment.