Hand tremor

Introduction Hand tremor is an involuntary, rhythmic shake caused by repeated contraction and relaxation of muscles. Everyone has varying degrees of tremor, called physiological tremors, but most of the tremors are too light to be noticed. According to the speed, rhythm, frequency of occurrence and severity of tremor, it can be classified. When exercise tremor occurs in muscle activity, resting tremor occurs when the muscle is resting, that is, when the patient is completely relaxed. This type of tremor can be one of the symptoms of Parkinson's disease. Intentional tremor occurs when a certain posture is taken. Idiopathic tremor usually begins in childhood and gradually becomes apparent as the age increases. The cause is still unclear. Senile tremor is also an idiopathic tremor that occurs in old age. If a patient with essential tremor has a family history, it is sometimes called familial tremor.

Cause

The causes of hand tremor are both functional and organic. Functional tremor is mostly caused by factors such as emotional agitation, overwork, and physical weakness, and generally does not require treatment. More common diseases of organic tremor are:

Midbrain lesions are most evident with hand tremors. Anticholinergic drugs should be used for treatment.

Cerebellar lesions are prone to intentional tremors. For example, when the toast is imported, the hand shakes badly, it is difficult to complete a specific movement, accompanied by walking, stuttering and so on. Taking drugs such as diphenhydramine can improve symptoms.

Arteriosclerosis can lead to incoordination of autonomic movement. One of the symptoms is hand tremor, and head tremor occurs in severe cases. The cause of the disease needs to be treated.

Writing tremors are difficult to write with pens, but they do not tremble when engaged in other hand fine movements. It is caused by dysfunction of the cerebral cortex, and the treatment is mainly based on psychological therapy, and enhances physical exercise and local functional exercise; if necessary, it is treated with drugs such as diazepam, oryzanol and schisandra syrup.

an examination

Related inspection

Brain Doppler Ultrasound (TCD) Brain CT examination Cerebral blood flow brain evoked potential

1 Parkinson's syndrome tremor. It is the characteristic exercise involvement of the disease. It usually starts from one hand or upper limb, and then reaches the lower limb, and it affects to the opposite side in a few months or years. The tremor of the hand is often expressed as the movement of the metacarpophalangeal joint with the thumb, which is called the "saling pill"-like movement, which is a characteristic manifestation of the tremor of the disease. The most obvious tremor in the lower extremities is the knee joint, which can be manifested as flexion and extension-like movement; flexion, extension or torsional tremor can occur in the head. The tremor frequency is 4 to 8 Hz. Tremors occur at rest (resting tremors) and are often temporarily or completely inhibited when the limbs move autonomously.

2 senile tremor. Older age, different from Parkinson's syndrome tremor, is relatively small and rapid, occurs in voluntary activities (active tremor), and can occur at rest after the disease develops. The tremor occurs most prominently in the upper extremities, especially in the head tremor, which is characterized by rhythmic movements of the head, which can be combined with muscle weakness and muscle rigidity.

3 benign or idiopathic familial tremor. This type of tremor is an autosomal dominant genetic disease. It usually develops after the age of 20, and the prevalence increases with age. Postural tremor is the only symptom of the disease, and tremor may be systemic; affecting fine movements when the hands are affected, and small nodding or shaking heads when the head is involved. The tremor frequency is 4 to 8 Hz, and the amplitude is uncertain, which is exacerbated during stress. The disease progresses slowly without other neurological abnormalities. Propranolol or ketamine can relieve symptoms.

Differential diagnosis

Need to be identified with the following symptoms:

Limb tremor: Parkinson's syndrome is a degenerative disease of the substantia nigra and nigrostriatal pathways in adults over the middle age. The American APDA said that people who were younger than 40 years old began to have young Parkinson's disease. The etiology of primary tremor paralysis is not known. About 10% of patients have a family history; some patients may have encephalitis, cerebral arteriosclerosis, brain trauma, hypoparathyroidism, carbon monoxide, manganese, mercury, cyanide, and blood. Ping, phenothiazine poisoning and antidepressants (methylamine oxidase inhibitors, etc.) can cause Parkinson's disease-like Parkinson's syndrome.

Involuntary tremor of the limbs: In daily life, we often see some elderly people's hands, heads or lower limbs involuntarily shaking or swinging back and forth, which has a certain impact on the lives of the elderly. In fact, because many causes can cause limb involuntary tremor, it is necessary to identify the treatment. Tremor refers to the shaking and shaking of the head and limbs. Paralysis refers to the inability of a certain part or all of the limbs to move autonomously. Common in Parkinson's disease.

Hand and lip tremor: In patients with acute alcoholism, due to a large amount of alcohol consumption, the patient presents with a special state of excitement, emotional irritability and instability, increased speech, repetition, exaggeration, and sometimes dissatisfaction with usual , loudly insulted, there are aggressive behaviors; at this time the mouth is unclear, the lips of the hand tremble, the walking is unstable, and the face is flushed, and the heart rate increases.

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