Tremor

Introduction Tremor is a disease with the head or limb shaking and shaking as the main clinical manifestation. The lighter only has a head shake or a slight tremor in the hands and feet. The head of the heavy person is shaken and shaken. There are even twist-like movements. The hands and upper and lower limbs are not trembled, or both are strong and the limbs are in a hurry. Involuntary movements caused by certain diseases of the vertebral body of Western medicine such as tremor palsy, chorea, and tachycardia.

Cause

Physiological tremor: In some cases, most normal people have subtle rapid tremors on their hands when the upper limbs are stretched forward. Intensification of physiological tremor can be seen in anxiety, stress, fatigue, metabolic disorders (eg, alcohol withdrawal, thyrotoxicosis), or the use of certain drugs (eg caffeine and other phosphodiesterase inhibitors, beta-adrenal gland) A prime agonist, adrenocortical hormone).

Primary (benign hereditary) tremor: A subtle to coarse slow tremor that usually affects the hands, head, and vocal cords. There are autosomal dominant genetic factors in 50% of cases. The tremor can be unilateral. The tremor is mild or non-occurring at rest. When the patient performs delicate movements, it can cause tremor. Under the influence of any factor that can strengthen the physiological tremor, the primary tremor will also increase. As the age increases, the incidence of primary tremor increases, and is occasionally mistakenly referred to as senile tremor.

Tremor of cerebellar disease: Intentional tremor (as seen in multiple sclerosis and other cerebellar efferent disorders) occurs when the moving limb approaches the target. Supportive (positional) tremor is a large, rotational tremor at the proximal end of the limb that is most pronounced when the patient attempts to maintain a fixed posture or load. Shaking is a large tremor of the head and body. It is also a kind of supportive tremor. It is obvious when maintaining an upright posture and disappears after lying down. Flap-like tremors are seen in cases of hepatic encephalopathy and other metabolic encephalopathy. When the patient stretches out his hands forward, a large, slow, non-rhythmic movement occurs.

an examination

Related inspection

Brain CT examination, nervous system examination, thyroxine (T4) cerebrospinal fluid myelin basic protein fragment cerebrospinal fluid myelin basic protein

Genetic testing

It is an important means of diagnosis. The PCR method detects the copy number of CAG in the IT5 gene. The normal person does not have more than 38 copies, and the number of patients is more than 39. No overlap has been found so far. The positive rate is high. It is only necessary to test the patient himself. Pre-symptomatic diagnosis and prenatal diagnosis.

2. EEG

There may be diffuse abnormalities and no specificity. Mainly for low-wave amplitude fast-wave, especially the frontal lobe is obvious, the abnormal rate accounts for 88.9%. The alpha activity is reduced or absent and the amplitude is reduced. The visual evoked potential amplitude is reduced, but the first wave partial latency is normal. Patient P100 is not normal, and detection of P300 may be an objective indicator of early intellectual impairment in this disease.

3. Imaging examination

Head CT or MRI has important clinical value for the diagnosis of Huntington's disease. The typical imaging features are atrophy of the bilateral caudate nucleus, which causes the lateral ventricle of the lateral ventricle to face outward. SPECT examination showed that the blood flow in the caudate nucleus and the lenticular nucleus decreased significantly, and the blood flow in the frontal and parietal lobe also decreased, which was related to the pathological changes in these parts of the patient. PET showed a significant decrease in glucose metabolism in the caudate nucleus, and a decrease in metabolic activity in the caudate nucleus may occur before atrophy of the caudate nucleus.

Differential diagnosis

Liver and kidney deficiency type [testimony]: flutter unhealed, and also see dizziness, tinnitus, insomnia and more dreams, backache, soft feet, limbs, big, stupid, forgetful, tight veins, clumsy movements. The tongue is thin, the tongue is dark red and less mossy, and the veins are thin or dense.

Qi and blood deficiency type [testimony]: flutter for a long time, faceless, shy, dizzy. The tongue is pale and has a tooth print or dim, and the pulse is weak.

[Certificate]: Flutter or light or heavy, can still be homemade, often chest tightness, thick yellow, dizzy dry mouth. The tongue is yellow and thick, and the pulse is slippery.

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