Trimmer for grass symptoms and causes of the development of the disease. Tremor species in children
Tremor is involuntary rhythmic oscillatory movements of the body part (arms, legs, head, vocal cords, trunk), arising a consequence of the constant contraction and relaxation of muscles.
- normal (physiological). as a rule, almost invisible, and many people become noticeable only with physical and emotional stress;
- abnormal (pathological) caused by a disease or drug.
In addition, the tremor is classified according to the reasons causing them, namely:
- Physiological (ordinary weakly expressed tremor found in all people)
- Essential (common violation, other symptoms are rare)
- Cerebellar (occurs as a result of damage to the cerebellum)
- Secondary (manifestation of the underlying disease or the result of the drug)
Signs: excitement and small tremor 24–72 hours after the last dose of alcohol or sedative. Sometimes high blood pressure, rapid palpitations, fever, especially often in hospitalized patients.
Signs: Rough or small slow tremor. Slow, for many years, deterioration. Usually spreads to both hands, sometimes to the head and vocal ligaments. Often has a family character. Other symptoms of disorders in the nervous system are absent.
Hormonal, metabolic and toxic disorders
- Brain damage as a result of oxygen starvation (anoxic encephalopathy)
- Liver failure (causes brain dysfunction, which is called liver encephalopathy)
- Thyroid hyperactivity (hyperthyroidism)
- Renal failure (causes brain dysfunction, which is called uremic encephalopathy)
- Hyperactivity of the parathyroid glands (hyperparathyroidism)
- Low blood sugar (hypoglycemia)
- Poisons, including heavy metals (for example, lead)
Signs: Slow tremor with changing frequency. Sometimes chin or leg are involved. At first, usually one.sided.It is accompanied by other symptoms, such as muscle rigidity, small unsteady handwriting, slowed movements, shuffling gait.Many patients have no relatives who would suffer from Parkinson’s disease or tremor. After alcohol, the tremor does not decrease.
Signs: sometimes rude or intermittent tremor. In middle.aged people who are difficult to look down and less often up, muscle stiffness, difficult movements and dementia.
Tremor, due to cerebellar damage
- Chronic alcoholism
- Ataxia Friedreich
- Hemorrhage in the brain
- Head injury
- Multiple sclerosis
- Spinocerebellar ataxia
- Brain tumor
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Signs: variable frequency and amplitude.Often arises when trying to reach the subject and intensifies as it approaches it. Often intensifies when the patient holds the limb of elongated in front. Accompanied by other symptoms indicating nerves damage: weakness, tingling sensation, loss of sensitivity.
Signs: It begins suddenly and may also stop. Variable frequency and amplitude. Decreases when the patient is distracted.
Inner tremor of the body
Each person at least once experienced a trembling throughout the body when he froze. However, hypothermia is far from the only reason for the appearance of such sensations. Often trembling occurs with severe stress, it is triggered by constant restraint of emotions. Some of the factors causing the internal tremor of the body can even lead to disability and carry a danger to life. For example, such trembling arises as a result of the development of serious oncological or cardiovascular diseases. Therefore, you should not ignore even minor manifestations of internal tremor and at the first opportunity should be contacted by the hospital.
Information from this section cannot be used for self.diagnosis and self.medication. In case of pain or other exacerbation of the disease, diagnostic examinations should be prescribed only by the attending physician. To make a diagnosis and proper prescription of treatment, you should consult a profile specialist.
The causes of the inner tremor of the whole body
Even infectious diseases can cause a feeling of trembling. When the internal tremor of the whole body appears, the reasons often lie in the depletion of nerve cells. Most often, the following factors lead to this:
Also, a fairly common cause of internal tremor of the body is the wrong diet. With a deficiency of macro and microelements, a violation of the nutrition of neurons occurs, which, in turn, leads to the appearance of trembling. It can also provoke malfunctions in the work of the highest centers of regulation of the autonomic system. These include cerebellum, thalamus and hypothalamus, as well as the crust of the brain. Violations in their work are often associated with the development of tumors. Also, with tremor of the whole body, causes can lie in impaired blood circulation, which causes pathologies such as brain ischemia.
Treatment of trembling in the legs
If you are sure of the benign tremor of the legs, then you can use folk home methods. With a nervous disorder, tea decoctions and soothing tinctures will help well. Otherwise, you need to contact a psychologist and start taking medications acting on the central nervous system.
You can take antitromerly drugs, but they always have contraindications and side effects (reducing concentration and weakness, so you can not get behind the wheel and work in a particularly difficult environment). You need to be careful and first consult a good profiled doctor.
With strong trembling, interfering with motor function, surgical methods are used. It is possible to use manual therapy: massage and orthopedic techniques.
There is a special treatment with physical exertion on the necessary muscle areas of the body. The effect of certain nerve impulses of the muscle can help isolate trembling in the legs.
Trembling of the head. Medication therapy
In cases where the tremor leads to limiting professional or homework, therapy is indicated, the choice of drugs for which it is carried out taking into account the expected safety and efficiency. The safest and most effective drugs (the level of evidence and, according to the expert commission of the American Academy of Neurology) include the beta-blocker Propranolol and anticonvulsant primidon. The effectiveness of propranolol and primidon, which are traditionally called the preparations of the first choice, is approximately the same.
The doctor may recommend abandoning caffeine and other stimulants, as well as drugs that cause tremor. In some cases, injections of botulinum toxin have a positive effect. The drug is administered into the affected muscles to temporarily relax them, thereby reducing the severity of the tremor. Injections must be repeated 2-4 times a year. This method is more effective in the treatment of tremor of the head or vocal cords. Surgical treatment is required in severe cases. A neurologist can offer you various treatment options. Surgical treatment of ET: Talamotomy: an operational method that destroys part of the Talamus brain. Stimulation of deep brain structures: an operational method in which small wires (electrodes) are placed in the brain in the thalamus and connected to the device.
Trembling in the hands (essential tremor)
Essential tremor (ET) is one of the most common motor disorders in the world and is characterized by postural and / or kinetic tremor. Despite this, the Office for Products and Medicine Control (FDA) approved only one medicine (proponolol) for its treatment. Surgical procedures, such as deep brain stimulation (ventral intermediate thalamus core). offer treatment of refractory tremor. Although the disease is usually called “benign”, it often causes difficulties in performing everyday tasks, such as writing and eating. In the last decade, progress has been observed in the understanding of the essential tremor. Including the discovery that “non.measured symptoms”, including mood and cognitive dysfunction, are more often found in patients with essenic tremor than normal.
ET is more common than Parkinson’s disease (PD) or Alzheimer’s disease, and there is not a single population of the world that would be immune to its development. According to experts. The prevalence of the essential tremor adjusted for age and floor is from 3 to 4 to 1000, and the annual incidence. 23.7 per 100,000. The incidence increases with an increase in age. although the disease can also affect children. Approximately 4% of adults aged 40 and older suffer from essential tremor. Family history of ET, apparently, correlates with an earlier age of the onset of Tremor. Despite the fact that there is no convincing evidence that ET increases the risk of mortality, one longitudinal prospective study revealed a slight increased risk of death in patients with ET.
Essential tremor is considered a heterogeneous state with a variable clinical expression in patients. It is characterized by postural and / or kinetic tremor in the frequency range from 4 to 12 Hz. The frequency of tremor usually decreases over time, and the amplitude slowly increases. Alcohol temporarily reduces the amplitude of the tremor in 50-90% of cases, although it can again worsen after the effect of alcohol ceases. About 90% of patients have tremor in the upper limbs, in 30%. Tremor of the head, 20%. “trembling voice”, 10%. Tremor of the face or jaw, and 10% of patients with ET can have the tremor of the lower extremities. At least 50% of patients with ET have disturbances in tandem gait. Blocation revealed the presence of “non.measured symptoms”, including moderate cognitive changes, depression, anxiety, social phobias, olfactory disorders and hearing impairment, which are more often found in patients with essential tremor. than control persons. Unfortunately, according to estimates, ET is incorrectly diagnosed in 30-50% of cases, one of the criteria is the duration of Tremor for more than 5 years. Three ET subtypes are distinguished: hereditary, sporadic and senile.
Tremora assessment scales are used to evaluate ET, especially in clinical trials. Usually used TRS is the Fahn-Tolosa-Marin rating scale, which is filled with medical workers. ET is usually inherited by autosomal-dominant transmission with incomplete penetrance. In some families, the program is polygenic. The exact pathogenesis of ET is unknown. The disease can be caused by the “central oscillator” arising in the triangle of Guine-Mollar, located in the brain stem. Other areas of the brain that are involved in pathogenesis are the lower olive core and cerebellum. Evidence of the involvement of the cerebellum includes the presence of “torpedoes” or “swelling of the axons”, which were found in Purkinje cells in some patients with essential tremor. Whether ET is a neurodegenerative disease or non.generative disease, remains controversial. The detection of pathology in the form of Taurus Levy in some patients with ET and Purkinya cell loss in others indicates a neurodegenerative process. However, the essential tremor can be caused by abnormal vibrational dysfunction of the motor system, which suggests that this is not the primary neurodegenerative disease, but the disease in which it can be secondary damage to neurons. The increased excitability of membranes in motor circuits can play a key role in pathogenesis. Several studies suggest that there may be a connection between PD and ET, although it remains controversial.
Pharmacological treatment of essential tremor should be considered when tremor interferes with everyday life. Proper treatment depends on the correct diagnosis, and other possible causes of tremor should be excluded. Patients must be informed that treatment does not heal the disease, but may offer a weakening of tremor. Medicines that are used to treat et. These are those used to treat other diseases, such as hypertension and cramps. Unfortunately, from 30% to 50% of patients with essencal tremor do not respond to drug therapy. The pharmacological agents of the first line used to treat ET are propranolol and primidon, although it was shown that other drugs, including Sotalol, Atenolol, alpraisals and topiramate, also provide a decrease in tremor. Beta-blockers and calcium channel blockers are drugs that are usually used to treat hypertension and other cardiovascular diseases.
Propranolol (Indural). A non-chief antagonist of beta-adrenergic receptors that effectively treats tremor and is the only drug approved by FDA for the treatment. The average dose of proponolol in published controlled studies was 185.2 mg / day. Propranolol is also available in the form of a long.acting drug with a single daily dosing. It was shown that other antihypertensive drugs, including Atenolol (tenormin) and Sotalol (Sotakor), are reduced compared to placebo. There is also a limited amount of evidence that they are durable (Corgard) and Nimodipin (nimotop) can be treated. Primidon (Mizolin) is an anticonvulsant agent that effectively treats essential tremor. Studies using accelerometry and clinical scales demonstrated a decrease in the value of tremor by about 50% when using a primordon, which makes it first.line treatment. The primidon is associated with frequent side effects, including sedative effect, nausea, dizziness and acute toxic reaction, which usually intensify shortly after the start of treatment. It was not shown that a lower initial dose and slower titration reduce side effects compared to the initial dose of 25 mg per day.
Much depends on the intensity and amplitude of trembling hands in a child. The frequency of seizures is also taken into account. If a child has tremor for emotional reasons, then there are no reasons for excitement. With age, this symptoms will disappear.
With states caused by endocrine pathologies, long.term specific treatment will be required. It is possible that the cause of tremor is a hereditary disease. For example, such symptoms can be observed with Wilson-Konovalov’s disease. The essence of this pathology is in violation of copper exchange. Also strong tremor of the hands in children is observed with thyrotoxicosis.
If the child is caused by an endocrinological disorder, parents should immediately contact a profile specialist. In the multidisciplinary children’s center “Edkarik”, our small patients will be able to undergo an examination on the most modern equipment. To clarify the diagnosis, the doctor will prescribe the following procedures:
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- general tests;
- Ultrasound of the thyroid gland;
- CT brain;
- EMG or electromyography is considered the most advanced method that allows objectively assessing muscle activity, as well as describe the scope of amplitude and the frequency of trembling in the hands;
- Electroencephalography will evaluate the work of the brain;
- MRI. This is the most accurate method for identifying neoplasms in the early stages of development.
A children’s endocrinologist will certainly prescribe tests for hormones if there is a need. An important role in making a diagnosis is played by information about diseases transferred by the child, and a possible hereditary burden. Based on the data obtained, the specialist will be able to establish the cause of the limb tremor, and prescribe adequate treatment to the patient.
Diagnosis of tremor
To make an accurate diagnosis, you will need to undergo a number of examinations. The process is easily accelerated if the patient guesses what exactly has launched the disease, for example, when he confesses to alcohol abuse or many years of smoking.
Otherwise, blood tests describing the condition of the endocrine system, CT and MRI of the brain, examination of the neurologist and even a conversation with a psychiatrist may be prescribed.
Genetic studies can be carried out to identify a hereditary predisposition to tremor of the limbs. In this case, only symptomatic therapy will help.
List of drugs from tremor hands
Neurologists share medicines that can calm the uncontrolled trembling in the limbs, into several groups:
Anticonvulsants inhibiting the processes of the nervous system.
Inhibitors weakening nerve impulses.
Antidepressants restoring the emotional background.
Nootropics that provide active blood circulation in the brain.
You can free yourself from trembling yourself only in cases where the tremor is caused by stress, excitement or bad habit. In all other cases, it will be possible to get rid of the problem only after consultation with a qualified specialist.
The reasons for the tremor of the hands
If a person has a trembling of the upper extremities for a long time, he needs to check the state of his health. There are many factors that can provoke tremor of the hands, and its causes are not always harmless. They can talk about the development of serious diseases that require urgent treatment. Experts distinguish the following main causes of tremor of the hands:
- hereditary predisposition;
- thyroid diseases;
- Brain trunk damage;
- kidney diseases;
- cerebellar dysfunction;
- damage to the subcortical structures of the brain (Parkinson’s disease).
With hereditary tremor of the upper extremities, as a rule, people in old age face. Much less often such a problem appears in children. Shaking begins when it is in one pose for a long time. With pathological tremor of the hands, strong amplitude movements occur. Only a qualified doctor can diagnose a pathological tremor of the hands and its causes. Therefore, do not postpone a visit to a specialist if you observe such symptoms.
Tremor of the left hand
The problem is capable of both the upper limb and apply to both. A rarely appearing and short tremor of the right or left hand does not signal serious problems, but it is not worth leaving it unattended. Strong depression, taking some drugs can provoke such a condition. People who drink a lot of coffee or strong tea can complain about the appearance of tremor. In this case, the problem does not need urgent treatment. People who play sports often face the tremor of the right or left hand. Strong physical activity cause this condition.
In order to deal with the problem once and for all, it is necessary to find out what it is provoked. Many do not even know which doctor heals from tremor of the fingers. Doctor will help to cope with such problems:
Essential tremor with neuropsychiatric disorders
The phenomenology of trembling fingers is diverse and multifaceted. In addition to kinetic and postural trembling hands. highlight “tremor of intention” and “tremor of peace”. In several studies, postural instability and mild or moderate ataxic gait, with the exception of cases observed during normal aging, were demonstrated in patients with essential tremor. and especially in patients with other signs of cerebellar damage (for example, “tremor of intention”). It is intense to note that this ataxic gait can actually improve with the introduction of low doses of ethanol. In addition to these problems with a gait, patients with essencal tremor also have subtle eye impairment. What again implies the involvement of the cerebellum at the clinical and physiological levels.
Essential (main) tremor. The most common type of pathological tremor in humans; In some studies, it is twenty times more common than Parkinson’s disease. The most important symptom in patients with essential tremor is a kinetic tremor with a frequency of 8-12 Hz (t. e. tremor arising during an arbitrary movement) of the hands, and sometimes the tremor of the head and even the “voice”. Only in the United States, according to a number of authors. 13 million people suffer from the essential tremor. According to researchers. The prevalence of essential tremor is 4.0-5.6% among people aged ≥ 40 years and 9.0% or higher among people under the age of 60 years.
Over the past decade, clinical literature that constantly increases in its volume implied that the cerebellum could be centrally involved in the pathogenesis of the essential tremor. Firstly, pathology from the side of the cerebellum. With deviations in tandem gait and balance violations, have been repeatedly described in patients with essential tremor. Note that a pronounced hand tremor occurs in 58% of patients with essential tremor. and in 10% of patients with this tremor it spreads to the head. Secondly, it was reported that the unilateral cerebellar stroke abruptly stops the Ipilateral Tremor of the shoulder with the essential tremor, and the “shutdown path” of the cerebellum is the goal of deep stimulation of the brain, which, as you know. is an effective method of treating essential tremor. In addition, numerous studies of neuro-visualization have provided evidence of the defeat of the hemispheres and dysfunction of the cerebellum under the essential tremor, including functional magnetically. resonance tomography (MRI). Positron. emission tomography and [1 h] magnetically. resonance spectroscopy of tomography (MRSI).
At the beginning of this century, researchers have determined that there are identified structural pathological changes in all studied genes in essential tremor. And these changes, apparently, were of two types. The most common type of essential tremor (more than 75% of patients) was characterized by obvious changes in the cerebellum, including proximal swelling of the axon’s cells, which are probably a cellular response to injury). Reducing the number of purquin cells by 40%, purocyte heterocytosis and swelling of dendrites. The second type of essential tremor was characterized by Levy Taurus, limited mainly by the Ceruleus locus; At the same time, the cerebellum did not have a loss of purquin cells.
The traditional view of the essential tremor. sweat that the latter is a monosymptom. characterized by trembling of the fingers. However, over the past decade, researchers have discovered. that this picture of the essential tremor is an excessive simplification. Firstly, it became clear that many patients, in addition to tremor, also have other motor disorders (for example, ataxic gait). Secondly, now with the essential tremor, the presence of a set of “non-meter disorders” is recognized not only cognitive. but also other mental disorders. At the same time, “soft cognitive changes” (especially functional dysfunction) were recorded in several studies of patients with essential tremor. Two studies based on the study of the population demonstrated the connection between the essential tremor and dementia.
Mental disorders with essential tremor include specific personality traits, anxiety (anxiety). social phobia, and depressive symptoms. Depression can be the main manifestation of the disease, and not a secondary answer to the presence of tremor. As with other neurodegenerative diseases. Essential tremor. Apparently more than the disease of the motor system.
Cognitive characteristics in patients with essential tremor. especially problems with the executive function, were first evaluated in the study of m. Gasparini et al. (2001), and then confirmed by other researchers in the same year. In addition, patients with the essential tremor demonstrated significantly lower than expected, assessments by measures of complex auditory and visual attention, verbal fluidity and immediate response. These types of deficits can reflect difficulties with initiating and maintaining information processing strategies; A similar mechanism is believed to underlie cognitive changes in patients with Parkinson’s disease. The observed cognitive deficits seem similar to those that occur after cerebellar lesions and dysfunction of this brain structure. And thus, they are consistent with the dysfunction of the cerebellar thalamo-cortical path. In a population study j. Benito-Leon et al (2006)., forgetfulness was noted in 50.4% of patients with essential tremor. A study conducted in 2006 in Madrid J. Benito-Leon et al. For the first time demonstrated that the chances of the appearance of dementia are almost twice as high among the earlier cases of essential tremor.
Observation regarding that. that the essential tremor. Apparently, it is associated not only with moderate cognitive changes, but also with an increased risk of dementia, causes some question. Why it took so much time. so that this hypothesis becomes relevant ? A parallel with Parkinson’s disease can be drawn here, where the latency from the initial description of the disease to the assessment of cognitive deficiency was more than 150 years. After all, patients with Parkinson’s disease and essential tremor are often elderly, and there is a tendency to attribute their cognitive disturbances and dementia of old age.