The 64-year-old German Chancellor Angela Merkel was visibly shaking as she stood alongside Antti Rinne today: Video

German Chancellor Angela Merkel was seen shaking as she met Finland's visiting prime minister on Wednesday - her third shaking bout within the last month. 

Footage from the event shows Merkel's body shook as she stood outside with Antti Rinne while watching military honours to mark his arrival.   

This follows another incident just under two weeks ago, on June 27, when German Chancellor Angela Merkel's office sought to calm nerves after her second bout of uncontrolled trembling in just over a week. 

                                  

During the earlier incident, on June 27, the 64-year-old Chancellor's arms and body could be seen noticeably trembling as she met Germany's President Frank-Walter Steinmeier. 

It came just hours before she was due to board the plane to the G20 summit in Japan, sparking new questions about her health.

At the time, a German government spokesman said Merkel would not cancel any upcoming appointments - saying 'The chancellor is well.' 

Merkel's spokesman Steffen Seibert later tweeted she was on the way to Osaka for the G20 summit, and that 'numerous bilateral talks with other leaders are planned'.

Close-up footage showed the difficulty she was having trying to keep the quivering under control as she gripped her arms together.  

That second bout came 10 days after she blamed dehydration for the initial round of shakes she suffered during a meeting with visiting Ukrainian President Volodymyr Zelenskiy on June 18.

During that incident an aide rushed to her side to offer her a glass of water, which she declined.  

A government official said that while Merkel attributed the first tremors on June 18 to drinking too little water and too much coffee on a hot day, the second episode was more a psychological issue as she tried desperately to avoid a repeat. 

Medics have speculated over what caused her to shake, with suggestions ranging from an over-active thyroid to low blood sugar.

Most doctors, however, are in agreement that the shaking is unlikely to have been caused by dehydration or Parkinson's disease. 

Peter Garrard, a professor of neurology at St George's, University of London, told MailOnline during the German Chancellor's first shaking episode that her symptoms 'seemed to fit' those of orthostatic tremor - a rare neurological condition that used to be known as 'Shaky Legs Syndrome'.

On June 27, after seeing the second footage of her trembling as she met Germany's President, Professor Garrard said orthostatic tremor is still the most likely cause.

Orthostatic tremors often cause people to tremble in one or more parts of their body. This is often worse when they stand, with many sufferers having tell-tale 'shaky' or 'frozen' legs. The problem tends to resolve when they walk, sit or lie down.

Stress can make the shakes worse, which then becomes a vicious cycle as tremors cause the patient to become increasingly uneasy. There is no denying Merkel has a stressful job, however, it is one she has held for 14 years. This led many to dismiss suggestions her shakes may be down to nerves or a panic attack.

The tremors, which can last just a few seconds, can also come on for no apparent reason. The rare disorder tends to strike people in their sixties.

Over time, the condition can cause fatigue, pain and immobility. While there is no cure, drugs like Clonazepam can ease the symptoms.

Walking aids like scooters, sticks or even wheelchairs in extreme cases, may eventually be required. However, only Merkel's arms and hands have been seen shaking to date.

GP Dr Sarah Brewer, a medical director of Healthspan, told MailOnline the shakes could have been brought on by anything from an over-active thyroid to side effects from medication. 

One practitioner, Dr Mike Fitzpatrick, said in the wake of her meeting with Zelenskiy that the shaking may be a symptom of an infection.

'Honestly, to me it looks like an infection,' Fitzpatrick said. 'Sometimes when you have an infection, you'll find the body will shake.' 

'I read that there'd been some mention of dehydration but I don't think it looks like that to me. You wouldn't normally get shaking like that with dehydration,' he added.

'If you were starving, maybe, but thirst wouldn't do that to you.'   

After the ceremony with Steinmeier, Merkel went on to the Bundestag lower house of parliament for the swearing-in of the new justice minister. She showed no signs of shaking and looked relaxed, chatting and laughing with Vice Chancellor Olaf Scholz. 

According to German newspaper Bild, Merkel, who turns 65 next week,  is always accompanied by a doctor and a paramedic from the Ministry of Health's health service when she flies to international summits.   

It is not publicly known if Mrs Merkel, who has led Germany since 2005, has any health problems.

German privacy laws are very strict on that type of information being published by the media.

There were brief concerns about her health in 2014 when she was taken ill during a television interview. The broadcast was interrupted when she experienced a drop in blood pressure.

Seibert explained at the time the leader did not feel well for a moment, then ate and drank something and continued the interview.

Merkel is frequently called the European Union's most influential leader and the most powerful woman in the world.

She has said she will leave politics at the end of her current term, in 2021.

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