Resting tremor

Introduction Static tremor is a rhythmic tremor caused by alternating contraction of active and antagonistic muscles. Common finger-like action, frequency 4~6 times/s, appears at rest, aggravates during stress, relieves during voluntary exercise, sleep It disappears; it can also be seen in the lower jaw, lips and limbs. It is a characteristic sign of Parkinson's disease. Static tremor is a compound tremor, often accompanied by alternating pronation-spinning and flexion-extension movements, and does not appear in a single form, usually variable. In the early stage of the disease, static tremor has volatility, which is relieved or temporarily disappeared during voluntary exercise, but appears again after a few seconds. Later, tremor persists during voluntary exercise, and tremor is aggravated during emotional, anxiety or fatigue, but during sleep or Disappeared during anesthesia.

Cause

Most common in Parkinson's disease or Parkinson's syndrome (caused by toxins, cerebrovascular disease, encephalitis, trauma, etc.). The age of onset is small, and the corneal KF ring is hepatolenticular degeneration. A few are rickets of rickets.

an examination

Related inspection

EEG examination of brain CT

1. Blood copper: The total amount of serum copper is reduced.

2. Urine: The amount of urinary copper is increased. The penicillamine loading test is helpful, especially for early and early detection.

3. Abnormal liver function, anemia, white blood cells and thrombocytopenia.

4. In the brain CT, abnormal low-density shadows can be seen in the bilateral lenticular nucleus. The nucleus of the caudate nucleus, the dentate nucleus of the cerebellum and the brainstem can also have a density-reducing area. The cerebral cortex and cerebellum can show atrophic changes.

5. EEG abnormalities.

6. Tissue trace copper determination.

Parkinson's disease: High-performance liquid chromatography (HPLC) can detect a decrease in HVA (high vanillic acid) levels in cerebrospinal fluid and urine. Brain CT can have widening of the sulcus and enlargement of the ventricles.

Parkinson's disease or Parkinson's syndrome: The disease is associated with a decrease in dopamine content in brain tissue and a relatively hyperactive acetylcholine function, so it should supplement dopamine content and reduce cholinergic function.

Differential diagnosis

The most clinically confusing disease with ET (primary tremor) is PD or Parkinson's syndrome. Some scholars have found that there is a high proportion of ET in the family of PD patients. At the same time, there is a high proportion of ET in ET. -PD, and often the onset of ET precedes PD (Parkinson's disease), so some scholars believe that ET is a PD type. However, many scholars believe that ET and PD are two different diseases. Clinical identification mainly depends on the form of tremor and signs of the nervous system. PD can have action tremors, but resting tremors are more typical. Static tremor can be found in different parts of the body, often asymmetrical, and the most typical manifestation is the sputum-like action. It is caused by the flexion and extension of the elbow, the pronation of the forearm, and the movement of the thumb. The frequency is 4-6 Hz. The typical resting tremor disappears with the start of the exercise, and can also be converted to posture after the course of the disease. Dopaminergic medication usually improves tremors. In addition to different forms of tremor, PD also has signs of nervous system such as muscle stiffness and decreased movement.

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