Tremor in the head

Introduction Head tremor is a clinical manifestation of idiopathic tremor. It is an autosomal phenotype, the most common extrapyramidal disease, and the most common tremor, with a family history of about 60%. The only symptom of idiopathic tremor is tremor, occasionally reported with tone and mild gait abnormalities. The patient usually begins with the upper limbs, primarily affecting the upper limbs, and can also affect the head, legs, torso, vocalization, and facial muscles. It is characterized by positional tremor and can contain both motility, intentional or resting tremor components.

Cause

Causes: With idiopathic tremor, idiopathic tremor is an autosomal dominant genetic disease, the most common extrapyramidal disease, and the most common tremor disorder. About 60% of patients have a family history of common tremor In the hand, most patients have two-handed tremors after the onset of the disease, but also one-handed tremors, hand tremors, affecting fine movements, writing and catering.

an examination

Related inspection

Brain CT examination EEG examination

(1) CT, MRI, positron emission tomography (PET) or single photon emission tomography (SPECT), meaningful for differential diagnosis.

(2) Electromyography (EMG) can record 4-8 Hz evoked muscle-antagonistic muscle synchronous continuous release activity, and about 10% of patients show agonist muscle-antagonistic muscle contraction. Single motion unit analysis shows that electrical impulses are collective or synchronized. The newly recruited motion unit in the recruiting phase during the episode of tremor has an abnormally high instantaneous 20 to 50 Hz discharge frequency.

(3) Genetic analysis: It is of great significance for the diagnosis of certain hereditary dystonia diseases.

Differential diagnosis

Differential diagnosis:

1. Idiopathic tremor is an autosomal dominant disorder, the most common extrapyramidal disease and the most common tremor disorder, with approximately 60% of patients having a family history. Idiopathic tremor is a single symptomatic disease, and postural tremor is the only clinical manifestation of this disease. The so-called posture tremor refers to the tremor caused by the limb maintaining a certain posture, and the tremor naturally disappears when the limb is completely relaxed. The tremor of this disease is common in the hand, followed by head tremor, and very few patients have lower limb tremor.

2. Essential tremor (ET) is a common dyskinesia. Also known as idiopathic tremor, benign tremor. Often referred to as family history, it is also known as hereditary tremor or familial tremor. Dana first described the disease in 1887. For more than 100 years, despite extensive research on its etiology, pathogenesis, clinical features, diagnosis and treatment, it is still difficult to diagnose and there is no very effective treatment.

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