Tremor of the upper and lower extremities

All kinds of tremors stopped only in a dream.There are two main types of it - the physiological and pathological tremor.

physiologic tremor occurs in every healthy human.For example, when a strong anxiety, fear as a result of the interaction of the central and peripheral neurophysiological processes are performed repetitive contraction and relaxation of muscles.Such a tremor usually invisible from outside and is not felt by the person.If muscle tension, fatigue, cooling or emotional excitement tremors can be amplified and become noticeable - it is called the enhanced physiological tremor.It has a large amplitude, but the same frequency as the simple saline.

pathological tremor

arises in various diseases and is visible to the naked eye.It has a number of features.The basis of the clinical analysis of tremor - the definition of the states in which it manifests itself.

resting tremor

arises at a time when the muscles are relaxed and not make active movements.Increases with excitement and mental st

ress can be reduced with the active voluntary limb movements involved in the tremor.This type of tremor is most typical for Parkinson's disease.


Any tremor occurring during voluntary contraction of the muscles.It includes postural, and isometric tremor motion (kinetic).

Postural tremor occurs against a background of active muscle tension while maintaining the posture as opposition to the force of gravity.It can be a benign nature and is a manifestation of inheritance.It may mean increased anxiety, occur in diseases of the thyroid gland.Tremor of this kind can also trigger abstinence (breaking) due to the use of high doses of alcohol or drugs.In case of overdose of certain medicines or chemicals poisoning can also occur suddenly trembling, such as poisoning with salts of heavy metals (mercury).Postural tremor of upper and lower limbs better notice when the patient pulls out both hands and trying to spread his fingers - that is the job gives the patient a neurologist at inspection.

Isometric tremor occurs when the muscle when their action is directed against a stationary object (such as when the person rests his hands on the table).

Kinetic tremor occurs during voluntary movement.His option is kineziospetsifichesky tremor only in certain activities (by writing, in the performance of any professional function), but not in other movements involving the same muscles.

type of tremor, its spread, severity, age of onset and other characteristics form the shaking syndrome.Establishing the last important to determine the correct tactics of treatment.There are several

tremor syndromes of the upper and lower extremities.The most common is Essential.Usually manifested postural tremor of the hands, often in combination with a tremor of the head, mouth, vocal cords, legs, diaphragm.More than half of the patients is a hereditary benign disease that does not require special treatment.Jitter is significant doctor usually appoints propranolol or primidone.

Parkinsonian tremor is most often seen resting tremor, or a combination of tremor action.In typical cases involved the hands, there is slowness, difficulty in movement.Parkinsonian tremor may be reduced under the influence of the dopaminergic agents (levodopa, dopamine agonists), anticholinergics.

When cerebellar tremor is observed mainly intentsionnogo sweeping shake, combined sometimes with postural tremor of the upper and lower extremities.If there is a possibility of cerebellar pathologies different clinical forms of jitter (eg, rhythmic postural tremor of the head and torso - titubatsiya).The greatest concern deserves kind of tremor called asterixis, hand movements in which resemble the flapping of wings.It can occur due to Wilson's disease (severe hereditary disease associated with the accumulation of copper in the tissues of the brain, blood and liver), liver or kidney failure, defeat the midbrain.In the form of cerebellar tremor affects many neurotransmitter systems, and therefore the selection of treatment is difficult.

Holmes tremor is characterized by a peculiar combination of tremor and rest tremor action.Usually, it is peculiar to a sharp increase in attempts to hold the limb on weight.Rough, krupnorazmashistoe shake hands, legs and torso are often interrupted by a variety of jerks.Holmes tremor often occurs after vascular injury, multiple sclerosis and some other diseases.Treatment is problematic in some cases, help levodopa, holinoliti-ki, valproate, propranolol.

psychogenic forms of tremor

Have different clinical manifestations, an unusual combination of kinds of jitter (usually the limbs).Tremor begins suddenly and abruptly stops.If you divert the attention of the patient, the jitter is reduced.Requires counseling therapist and the appointment of anti-anxiety, sedative drugs.

Medical and toxic tremor may be caused by a number of substances.The most typical of the tremor, which is close on a number of its characteristics to enhanced physiological tremor.It can occur after applying the sympathetic-mimetic (ephedrine) or antidepressants (amitriptillin).Parkinsonopodobny tremor possible after treatment with antipsychotic or other antidofaminergi-cal drugs (reserpine, flunarizine).Intention tremor may contribute to the use of lithium salts and some other drugs.The tremor, which occurs after acute alcohol or drug poisoning, should be distinguished from tremors in chronic alcoholism, associated with damage to the cerebellum.

described tremor syndromes of the upper and lower limbs do not exhaust the whole variety of clinical variants.There are such an unusual combination that is not immediately possible to refer them to a category.This makes the inadmissibility of self and the need to see a doctor for examination and treatment selection.

In those cases where the effect of drugs in the treatment of tremor of the upper and lower extremities insufficient applied stereotactic brain surgery.Such operations are performed neurosurgeon Centre of Neurology and Neurosurgery.The progress made in the study of tremor, the emergence of new drugs that could help a growing number of patients, and optimistic about the future.

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