Essential tremor in medicine is called trembling of hands, facial muscles, tongue and other parts of the body. The prevalence of this disease is quite high - among neurological diseases tremor is the third most often diagnosed place after a stroke and epilepsy.
Causes of the disease
Essential tremor or tremor of the minor in most cases is a hereditary pathology - gene mutation is transmitted directly from parents to offspring. The disease affects the elderly, but is more often diagnosed in the elderly over 50 years.
Another cause of the disease is the incorrect interaction of certain brain structures( cerebellum, brainstem and red cores) responsible for coordinating the voluntary activity of muscles.
Symptoms of
The most typical manifestation of pathology is hand trembling - small- or medium-amplitude. In this case, muscle tone remains unchanged.
Trembling covers the wrist joints and finger joints. Physiologically, tremor is a rhythmic muscle contraction.
At the onset of the disease, tremor manifests itself only in tension and in the performance of some work. Then, the jitter may occur spontaneously at rest. The tremor amplitude increases with time, and the frequency, on the contrary, decreases.
Strengthening tremor is observed in emotional experiences, hunger, physical fatigue, the use of substances stimulating the nervous system( coffee, alcohol) and the effects of cold.
Also, the severity of symptoms can be triggered by the excitement of being in public places. Heavy manifestations lead to a loss of the patient's ability to work and ability to serve himself( to hold a spoon in his hands, to perform simple domestic activities).
Associated symptoms of the disease are:
- spastic torticollis( pathological position of the head);
- blepharospasm( involuntary contraction of the circular muscle of the eye);
- oromandibular dystonia( contractions of masticatory muscles);
Patients with arm tremors have a particularly difficult time receiving a letter - this type of activity leads to rapid fatigue of the muscles of the hand and forearm and the occurrence of so-called "writing spasm".
In contrast to Parkinson's disease, which is also characterized by trembling, essential tremor as an independent disease does not cause deterioration of cognitive abilities and dementia( dementia), which is why it is also called essential benign tremor.
Classification of essential tremor for localization
Essential tremor of the hands
The most commonly observed species of essential tremor. It is important not to confuse this type of tremor with hand trembling due to parkinsonism or age-related disorders of the musculoskeletal system.
Essential tremor of facial muscles
Mimic tremor is characterized by a trembling of the lips that occurs spontaneously when talking, or when the patient smiles. The patient's cheeks and temporal muscles may tremble.
Essential tongue and tremor
Less common than other types of tremor. The tremors of the eyelids and the tongue can be almost invisible to others, but they are well felt by the patients themselves.
Shivering timbre of the language and voice
Tremor can also be present in the vocal chords responsible for speech functions, which leads to a change in the voice timbre. At the same time, the person's voice becomes trembling and bleating, vibrating, stuttering and difficulties with pronounced pronunciation of words may occur.
Voice tremor develops mainly in elderly patients, especially those whose experience of illness is 10 years or more.
Iris Diaphragm
A rare type of pathology, evidenced by the radiographic method. The combination of jitter in the diaphragm, voice, lips and tongue causes specific changes in breathing and speech. Breathing becomes intermittent, and speech - illegible, jerky and difficult to perceive.
Essential foot tremor
Foot tremor is rare and occurs only in 20% of patients. Often, its manifestations are invisible or poorly expressed and diagnosed only by means of hardware research.
Essential tremor of the head
A common type of tremor. Caused by involuntary synchronous contraction of the cervical and facial muscles.
It can manifest itself as:
- single head nods;
- multiple nods - both up and down, and from side to side;
- constant shallow tremor of the head;
Symptoms usually increase with age.
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Classification by degree of severity
For the needs of therapy, medical personnel subdivide the tremor in terms of its severity into the following types:
- is light or present in periods;
- moderate;
- pronounced( delivering serious physical and psychological discomfort to a person and affecting its performance);
- significant( not allowing a person to do their job, and also hampering ordinary household activities);
Diagnosis
The medicine reveals this affliction with the aid of differential diagnosis.
The method of excluding from the list of possible diseases, for which the trembling of limbs and other parts of the body is also characteristic, are eliminated:
- Parkinson's disease;
- dystonia;
- Multiple Sclerosis;
- neurotic jitter;
- toxic damage;
- alcoholism;
- encephalopathy in hepatic insufficiency and other ailments;
The doctor making the diagnosis pays attention to:
- amplitude of the jitter;
- frequency;
- analysis of the patient's pedigree;
- propensity to drink alcohol;
- muscle tone;
- patient's posture;
- associated symptoms;
A variety of hardware and laboratory techniques for examining the patient are used:
- computed tomography and MRI( magnetic resonance imaging);
- angiography for the examination of the condition of the vessels of the head;
- electroencephalography for determining electrical brain activity;
- common( sometimes biochemical) blood test;
- genetic research;
- X-ray;
Treatment of
Like most neurological diseases, essential tremor is treated in a complex manner. It is used medicamentous, non-medicamentous and( if necessary) surgical treatment.
Medication
Drugs used in treatment are divided into several groups:
- beta-blockers of adrenergic receptors, reducing the severity of symptoms( propranolol, primidone);
- anticonvulsants, also eliminating jitter( clonazepam, gabapentin);
- tranquilizers of benzodiazepine group( diazepam, oxazepam, lorazepam)
- preparations with vitamin B6 intramuscularly( reduces the progression of the disease, affecting serotonin metabolism);
- intramuscular injection of small doses of Botox;
Non-pharmacological
Physiotherapy is a positive action, a physiotherapy exercise aimed at restoring muscle control and correct breathing when the diaphragm is shaking.
Contrasting souls, other water procedures, balneotherapy in sanatorium-resort conditions help from an essential tremor. The patient can be prescribed a special diet, relaxing and acupuncture massage, acupuncture.
Surgical
In severe cases, when treatment with medicines does not provide a healing effect or can not be used for other reasons( in the presence of allergies, serious diseases of the liver, stomach or kidneys), surgical intervention is prescribed.
There are two types of operations:
- The destruction of the nuclei of the thalamus( the area of the brain responsible for the connections between all the other departments).
- Neuro-stimulation of the brain. Electrodes are connected to the head, connected to a device that generates electrical impulses. These impulses stimulate the nervous system in such a way that the tremor disappears or manifests itself to a lesser degree.
The nervous tic of the eye is to some extent a manifestation of an essential tremor, or rather one of its variety.
Do not forget that perinatal encephalopathy of hypoxic origin can also provoke the development of limb tremor and face. More here.
Tremor of the lips in a newborn is a fairly common phenomenon, whether you should know about it by clicking on the link http: //gidmed.com/ bolezni-nevrologii /nevralgija/ tremor-u-novorozhdennyh-norma-ili-patologiya.html.
Treatment with folk remedies
Folk remedies include tremor treatment with bee venom, hirudotherapy( treatment with leeches) and phytotherapy. These methods give a short-term effect and can only be used under medical supervision.
Useful for relaxing muscles with relaxing autotraining and oriental self-monitoring practices. To significantly alleviate the condition can, in particular, Indian gymnastics for the fingers, called "yoga-mudra."
This practice uses different combinations of finger positions to achieve a harmonious flow in the body of internal energy flows.
Prognosis and complications
The main complication of the disease is a person's loss of working capacity and self-service skill.
Forecast moderately favorable - treatment, as a rule, significantly reduces symptoms, but it is difficult to completely relieve the patient of this ailment.
Prevention of
In the case of hereditary etymology, preventive measures for tremor do not exist. A preventive role can be played by genetic counseling of patients planning offspring.