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Tremor - Shaking hands (hand tremors) Causes and treatment. Parkinson or Physiological Tremor?
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Tremor means a rhythmic, involuntary oscillatory movement of a body part.
Commonly it is hand. Most Tremors are mild. Tremor is seen in nearly 5% of the population over the age of 40 years.
Tremor can occur during rest, or physical activity.
Rest tremor subside, when the involved limb is put into action.
Parkinsonian tremor is the most common cause of rest tremor.
Parkinson’s disease is the most common cause of rest tremor.
Classically, Parkinson’s diseases starts unilaterally. And it giving appearance as though the patent is trying to roll something in between his or her fingers.
This sign is called “pill rolling” tremor.
Beside hand, Rest tremor in Parkinson’s diseases also can involve: lips, chin, jaw, and legs and rarely the neck, head, or voice.
If person has rest tremor, Parkinson disease is so common that, most doctors directly diagnose them as Parkinson disease.
Other causes of rest tremor can be: multisystem atrophy, progressive supranuclear palsy, and corticobasal degeneration which collectively are called Parkinsonian syndromes.
Certain drugs, which have dopamine receptor-blocking property, can also produce rest tremor. These drugs include antipsychotics, antiemetics (metoclopramide), and antivertigo medications (prochlorperazine).
Other drugs also can cause tremors include:
These are valproate, calcium channel blockers (cinnarizine, flunarizine), selective serotonin reuptake inhibitors, lithium, tetrabenazine, and amiodarone.
Most Common cause of action tremor are: Enhanced physiological Tremor, Essential Tremor and cerebellar and psychogenic tremor.
Enhanced physiological tremor As the name suggests, physiological tremor occurs in all normal people, when muscles are actively used. Physiological tremor is not usually visible to the naked eye because its amplitude is very low. When this tremor becomes visible, due to increased sympathetic activity, it is termed as enhanced physiological tremor.
Enhanced physiological tremor is the most common cause of a postural tremor.
Patients typically give a history of the tremor surfaces only under certain conditions, such as stress, fatigue, anxiety, medication use, or caffeine intake. Moreover, such patients do not require to be investigated any further. They improve by removal of the offending agent.
The most common form is the enhanced physiological tremor due to drugs. Advancing age and consumption of multiple drugs is a strong risk factor.
Essential tremor ET is the most common tremor disorder, as well as the most common movement disorder described.
Essential Tremor is defined as a symmetrical postural tremor with or without kinetic component that involves hands and forearms lasting for more than 5 years and having a gradual onset and should not be explained by any other underlying disorder.
Age is a risk factor for the development of Essential Tremor, with the prevalence estimated to be 0.9% in people older than 65 years and increasing to 21.7% in the oldest old.
The tremor in Essential Tremor may involve other body parts such as voice, head, neck, and legs but not in isolation without the involvement of hands.
Management of tremor depends on underlying cause.
Parkinsonian tremor drug treatment involves L-DOPA or dopamine-like drugs such as pergolide, bromocriptine and ropinirole.
Essential tremor may be treated with beta blockers (such as propranolol and nadolol) or primidone, an anticonvulsant.
Enhanced physiological tremor is usually reversible once the cause is corrected. If symptomatic treatment is needed, beta blockers can be used.
Botulinum toxin, deep brain stimulation, essential tremor, head tremor, Parkinson disease, tremor, tremor rating scales
Commonly it is hand. Most Tremors are mild. Tremor is seen in nearly 5% of the population over the age of 40 years.
Tremor can occur during rest, or physical activity.
Rest tremor subside, when the involved limb is put into action.
Parkinsonian tremor is the most common cause of rest tremor.
Parkinson’s disease is the most common cause of rest tremor.
Classically, Parkinson’s diseases starts unilaterally. And it giving appearance as though the patent is trying to roll something in between his or her fingers.
This sign is called “pill rolling” tremor.
Beside hand, Rest tremor in Parkinson’s diseases also can involve: lips, chin, jaw, and legs and rarely the neck, head, or voice.
If person has rest tremor, Parkinson disease is so common that, most doctors directly diagnose them as Parkinson disease.
Other causes of rest tremor can be: multisystem atrophy, progressive supranuclear palsy, and corticobasal degeneration which collectively are called Parkinsonian syndromes.
Certain drugs, which have dopamine receptor-blocking property, can also produce rest tremor. These drugs include antipsychotics, antiemetics (metoclopramide), and antivertigo medications (prochlorperazine).
Other drugs also can cause tremors include:
These are valproate, calcium channel blockers (cinnarizine, flunarizine), selective serotonin reuptake inhibitors, lithium, tetrabenazine, and amiodarone.
Most Common cause of action tremor are: Enhanced physiological Tremor, Essential Tremor and cerebellar and psychogenic tremor.
Enhanced physiological tremor As the name suggests, physiological tremor occurs in all normal people, when muscles are actively used. Physiological tremor is not usually visible to the naked eye because its amplitude is very low. When this tremor becomes visible, due to increased sympathetic activity, it is termed as enhanced physiological tremor.
Enhanced physiological tremor is the most common cause of a postural tremor.
Patients typically give a history of the tremor surfaces only under certain conditions, such as stress, fatigue, anxiety, medication use, or caffeine intake. Moreover, such patients do not require to be investigated any further. They improve by removal of the offending agent.
The most common form is the enhanced physiological tremor due to drugs. Advancing age and consumption of multiple drugs is a strong risk factor.
Essential tremor ET is the most common tremor disorder, as well as the most common movement disorder described.
Essential Tremor is defined as a symmetrical postural tremor with or without kinetic component that involves hands and forearms lasting for more than 5 years and having a gradual onset and should not be explained by any other underlying disorder.
Age is a risk factor for the development of Essential Tremor, with the prevalence estimated to be 0.9% in people older than 65 years and increasing to 21.7% in the oldest old.
The tremor in Essential Tremor may involve other body parts such as voice, head, neck, and legs but not in isolation without the involvement of hands.
Management of tremor depends on underlying cause.
Parkinsonian tremor drug treatment involves L-DOPA or dopamine-like drugs such as pergolide, bromocriptine and ropinirole.
Essential tremor may be treated with beta blockers (such as propranolol and nadolol) or primidone, an anticonvulsant.
Enhanced physiological tremor is usually reversible once the cause is corrected. If symptomatic treatment is needed, beta blockers can be used.
Botulinum toxin, deep brain stimulation, essential tremor, head tremor, Parkinson disease, tremor, tremor rating scales
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