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What causes muscle tremors - the main causes of tremors. Why does tremor of the limbs and head appear: causes, types, diagnosis and treatment prognosis What is tremor in medicine

Promotional tremor (synonym - action tremor)– one of the types of tremor (along with resting tremor) – extrapyramidal hyperkinesis. It is an involuntary rhythmic oscillatory movement of a part of the body or the whole body during voluntary muscle contraction. It is divided into postural, kinetic (movement tremor) and isometric tremor.

Postural tremor occurs when maintaining a posture (tremor of arms extended forward or to the sides). May intensify or occur in certain positions (for example, when the patient holds his hands above his head or near the lower back). In this case, they talk about posture-specific postural tremor.

Movement tremor (kinetic) appears with any voluntary movement. There are simple tremor of movement (simple kinetic tremor), which occurs when performing non-purposeful movements (for example, raising and lowering the arm, flexion, extension, pronation of the arm). Intentional tremor (lat. intentio - goal, intention) is also distinguished - tremor during purposeful movements, for example, during the finger-to-nose and heel-knee test, in which the amplitude of the tremor increases as it approaches the final goal of the movement.

Isometric tremor occurs during isometric muscle work (muscle tension without movement), for example, when testing strength in the limbs or when placing a straight arm on a stationary surface. See also

Tremors are rhythmic, rapid contractions of the muscles of the trunk or limbs of an involuntary nature. Literally, the term muscle tremor means “trembling.” Trembling can occur during rest or exclusively during voluntary movement. Muscle tremors allow for rougher work. Fine motor activities are often difficult. For example, it is often difficult to thread a needle through the eye, or handwriting deteriorates significantly. Hypothermia, fatigue, increased concentration, and excessive muscle tension usually increase trembling. Most often, the described disorder affects the upper extremities, less often the proximal parts of the body. Tremors are most susceptible to people of older age, but it can also arise at a fairly young age.

Causes of tremor

Before finding out the factors that cause involuntary muscle contractions, it is necessary to answer the question: “tremor, what is it?”

Tremors are involuntary rhythmic contractions of muscle groups in certain parts of the body. More often than not, trembling is a signal of some kind of problem occurring in the body, and not a separate ailment.

Involuntary muscle contractions may be a symptom related to dysfunction in the areas of the brain that control muscles. In addition, tremors can occur as a result of a number of neurological disorders, such as multiple sclerosis, stroke, traumatic brain injury, and some neurodegenerative diseases that damage certain areas of the brain or cerebellum, such as Parkinson's disease.

There are a number of other factors that provoke the development of trembling of the body and limbs:

- atherosclerosis of cerebral vessels (due to the accumulation of cholesterol plaques on the walls of capillaries, narrowing of arterial vessels occurs), leading to the development of chronic pathology of cerebral circulation;

- Minor's disease or essential tremor, which is a hereditary benign disease and manifests itself as non-progressive tremors, most often of the neck muscles;

— dysfunction of the thyroid gland, causing increased production of hormones (thyrotoxicosis) and other pathologies of the endocrine system;

- abuse of alcohol-containing drinks;

- acute circulatory disturbance in the brain, especially in the area supplying blood to the cerebellum;

- tumor processes, abscesses in the cerebellum;

- degenerative disorders (olivopontocerebellar degeneration): a group of diseases with an unknown etiology, leading to the gradual death of brain cells;

- Wilson-Konovalov disease, which is a hereditary pathology, the essence of which is a violation of copper metabolism;

- side effects of certain medications;

- liver or kidney failure;

— poisoning with toxic substances;

- drug withdrawal;

- depressive states;

- a sharp decrease in blood sugar levels, the so-called hypoglycemia that occurs with diabetes.

In addition, tremors are often observed with excitement, emotional stress and physical fatigue. This is the so-called physiological tremors.

Tremor symptoms

To find out the symptoms of tremor, it is necessary to define tremor, what it is and its forms.

As was written above, trembling is most often a symptom of an illness, and not a separate disorder. It manifests itself in the form of involuntary rhythmic muscle contractions. There are two main types of this condition: pathological trembling and physiological. The first occurs as a result of serious dysfunctions of certain parts of the nervous system.

Pathological tremor is one of the symptoms of the disease. The second is a slight shaking that occurs under certain conditions in the outstretched upper limbs. This condition usually goes away quite quickly after the cause is eliminated. Such reasons include: excessive physical activity, various stress factors, use of certain medications, etc.

One of the types of physiological tremors is tremor during excitement. The appearance of involuntary muscle contractions during excitement is a fairly common phenomenon that can manifest itself in different ways. Most often it occurs as a result of a stressful situation or depression. Trembling with excitement is manifested by twitching of the hands and fingers, head, limbs or larynx. This type of trembling during excitement is just the body’s response to anxiety, excitement and usually goes away on its own.

If trembling is observed for several weeks, if it is not associated with taking medications, physical activity, stress, or excessive alcohol consumption, then there is a possibility that muscle contractions are caused by serious pathologies in the functioning of the body.

You can also classify jitter according to its prevalence - local and generalized jitter. The first is observed in certain areas of the body (tongue, head, limbs). Generalized muscle contraction is distributed evenly throughout the body.

Based on amplitude, tremors can be divided into the following forms: small-sweep and large-sweep.

Based on the characteristics of the manifestation of tremor, static and dynamic forms can be classified. The first form is a resting tremor, since this form is observed and most manifested in an unstressed muscle. The second form is action tremors, which manifests itself or intensifies during active movements. It, in turn, can be postural, intentional, or contractive. Postural trembling occurs or worsens when maintaining a position (for example, holding straight arms in front of you). Intentional muscle contraction occurs when performing small precise movements (for example, touching your nose with a fingertip).

Contraction tremor occurs or is aggravated when the muscle is held in a contracted state (for example, clenching the fingers into a fist for a long time).

Body tremor often occurs with abuse of alcohol-containing drinks or chronic alcoholism and is called alcoholic. The described type of trembling is manifested by “shaking” of the spread fingers, often spreading to the head or torso of the individual. This symptom is more often observed in patients in the morning and goes away after the next consumption of alcohol-containing liquids. The same situation is observed in drug-dependent individuals with withdrawal syndrome.

When using drugs or taking certain medications incorrectly, irregular small-scale trembling is observed in the fingers or hands. To eliminate this symptom, you must stop taking the drug.

Postural tremor is characteristic mainly of people suffering from autonomic dysfunction, excessively anxious and suspicious individuals. This form of the disease can be a consequence of pathologies of the thyroid gland, taking a number of drugs and alcoholic beverages, and may also have hereditary roots. This form of tremor is caused by chemical poisoning.

Postural tremor is small-scale and more pronounced when the arms are extended and the fingers are spread out. It intensifies when trying to concentrate, when the individual tries to reduce trembling, and does not disappear when moving.

Intentional oscillation occurs due to damage to the brain stem or cerebellum. With this form of trembling, large-scale muscle contractions are noted, which are absent at rest, but occur during purposeful movements, especially when achieving a goal. The patient, standing in a standing position with his eyes closed, arms straight and outstretched, is unable to touch his nose.

This form of trembling can be caused by tumor processes in the body, trauma, Konovalov-Wilson disease, vascular diseases, multiple sclerosis.

Generated by lesions of the cerebellum, pathologies of the structures of the subcortex and brain stem, it is constant.

The most dangerous type of involuntary muscle vibrations is asterixis. Its distinctive feature is its sweep, arrhythmia, and asymmetry of contractions. The shaking resembles the flapping of wings. This form is observed exclusively with voluntary muscle tension.

The described type of trembling is caused by a periodic paroxysmal decrease in the tone of the muscles responsible for maintaining a certain posture. That is why outwardly asterixis resembles a non-rhythmic, flapping trembling that appears when the hand is extended and the arm is straightened. A few seconds after straightening the arm, sharp tremors are observed, followed by an immediate return to its previous position. Similar twitching is detected during tonic tension of other muscles.

You can often observe bilateral asterixis that appears against the background. This is the main symptom of metabolic encephalopathy. Unilateral asterixis often occurs with a stroke.

Rhythmic myoclonus is characterized by widespread trembling of the entire body, which intensifies with muscle tension (during movement) and completely disappears with muscle relaxation. This form of tremors often accompanies the following ailments: various pathologies of the brain and vascular diseases, Wilson's disease, multiple sclerosis.

Parkinsonian tremor is a consequence of damage to the subcortical areas of the brain. Parkinson's disease is characterized by trembling at rest, which disappears or significantly decreases with the onset of activity.

Parkinsonian muscle tremor is often asymmetrical. This manifests itself in unequal intensity of shaking, for example, the left hand shakes more than the right. In this case, the oscillation decreases or completely disappears if the individual tries to perform a spontaneous action with this hand. With parkinsonism, movements are noticeably slower, but distinct.

Hereditary predisposition causes familial tremor, or as it is also called essential tremor. Most often it is observed in elderly individuals, less often in children. This type of trembling most often appears when trying to maintain a certain position. Essential tremor is characterized by fluctuations of small or medium amplitude with unchanged muscle tone. The twitching persists but is not aggravated by unsupported flexion of the upper limbs. Tremors at rest are observed much less frequently than in Parkinson's disease.

Essential tremor is considered the most common form of the disease in question. It often occurs in several family members. It manifests itself as trembling when performing any actions. In other words, tremor occurs when muscles tense and arms move. In twenty-five percent of cases, involuntary muscle contractions may be accompanied by a mild degree of torticollis, writing impairment (writer's cramp), a slight increase in the tone of the arm muscles, which never worsens to the level of rigidity characteristic of a number of diseases, for example, Parkinson's disease.

Familial tremor is considered one of the most common hereditary diseases of the nervous system.

Essential tremor is more pronounced during sleep. In addition, its manifestations are aggravated when the individual increases physical activity on the upper extremities, for example, when writing or buttoning up buttons. That is, with fine motor skills. This often leads to difficulty performing everyday tasks over time. For such people, assistive devices have been developed to help them perform everyday work. So, for example, special pens have been developed for writing, and other specific devices with a narrow focus have been developed for fastening buttons.

The intensity of essential tremor can be increased by drinking alcohol or emotional stress. In addition, familial tremor can often be accompanied by other neurological pathologies that cause other forms of tremor.

Rubral or midbrain tremor is observed with dysfunction of the midbrain due to a stroke, craniocerebral damage, less often, with a demyelinating or tumor process in the brain. It is characterized by a combination of the following forms of tremor: tremor in a state of muscle relaxation, postural tremor and pronounced intentional vibration. This form of tremor is found in the extremities opposite the area of midbrain damage.

One of the variations of psychogenic movement pathologies is psychogenic tremor. Clinical criteria for this form of tremor include sudden onset, wave-like or static, non-progressive course. In addition, psychogenic twitching is characterized by the presence of spontaneous remissions or remissions caused by psychotherapeutic treatment, the complexity of the manifestations of muscle contractions (all main forms of tremor can be observed with equal severity), and the effectiveness of placebo.

The course of the disease in question of any form is aggravated by the abuse of drinks containing caffeine, alcohol-containing liquids, mental stress, thyroid dysfunction, and the transition period.

Tremor treatment

The basis of any answer to the question: how to treat tremor? There is a high-quality and competent diagnosis that determines the form of tremor and the factors that provoked its development. Since the choice of therapeutic agents depends on the reasons that gave rise to the tremor.

Diagnosis of the disease that gives rise to tremors is often a rather difficult task, which can only be solved if the clinical manifestations are accurately described.

Hence, the most important principle in making a diagnosis is a clear distinction between the three types of tremor, namely, trembling in a state of muscle rest, intentional and postural tremor. So, for example, having identified a combination of these three types of tremor in one patient, it is necessary to describe and register them as separate independent forms. In this case, it is necessary to highlight the relative severity of each of the above varieties. For example, a patient may experience a rough tremor in a relaxed state, less pronounced postural muscle contraction, and even less pronounced intention tremor. A similar picture is characteristic of the trembling forms of Parkinson's disease. These same components of tremor outside the boundaries of Parkinson's disease are usually characterized by a different ratio - either postural muscle contraction predominates (inherent in severe familial tremor) or intentional (occurs with cerebellar pathologies).

Other essential principles that describe tremor and help establish the correct diagnosis, which leads to determining tactics for how to treat tremor, are the following: localization, motor pattern of oscillations, amplitude-frequency properties, syndromic environment of tremor.

Trembling can be localized in different parts of the body: on the upper or lower extremities, head, lower jaw, tongue, lips, neck, etc. Also, for proper diagnosis, it is necessary to take into account the distribution features (local or generalized, according to the hemitype) and other topographical features (for example, muscle contraction of the abdominal wall only, twitching of the eyeballs, orthostatic tremor, proximal accentuation of vibrations, symmetry/asymmetry).

The motor trembling pattern parameter includes the following characteristics: flexion-extension, flapping, pronation-supination, etc.

The amplitude-frequency characteristics parameter includes the severity of oscillatory movements, features of the course of trembling (onset and dynamics).

The syndromic setting of tremor is a description of all the neurological symptoms that accompany tremor.

Compliance with the above basics for diagnosing tremors will help you select adequate therapy.

How to get rid of tremors?

To get rid of essential tremor, the following medications are prescribed: benzodiazepines, beta-adrenergic receptor antagonists and Primidone. Beta-blockers aimed at reducing the amplitude of oscillations are considered most effective. Minimal doses of benzodiazepines can also reduce the severity of familial tremor. They can be used as monotherapy or in combination with beta-blockers. It is recommended to use these drugs in courses, since over time, sensitivity to them may develop.

Drug treatment for cerebellar tremor is often ineffective. An effective approach to the treatment of severe cerebellar tremor is microstimulation of the thalamus or stereotactic thalamotomy.

Propanolol is effective in treating alcohol tremors that occur after a hangover. Patients at a young age are often additionally prescribed beta-blocker drugs, since they are effective for high blood pressure. For elderly patients whose alcohol dependence is in an advanced stage, it is recommended to prescribe Primidon, since it does not have any side effects on the cardiovascular system.

Treatment for tremors caused by Parkinson's disease involves taking drugs like dopamine (Pergolide, Ropinirole). They should be taken with great caution, as they can give rise to the following manifestations: tardive dyskinesia, clonus and psychosis. It is also recommended to prescribe anticholinergic drugs (Benzatropine) and Amantadine to reduce the severity of parkinsonian tremors.

Patients with rubral twitching may find relief from anticholinergic medications or levadopa.

In addition, people interested in the answer to the question: how to get rid of tremors can use the secrets of traditional medicine. However, it is recommended to begin any independent relief from a painful symptom under the supervision of specialists.

The information presented in this article is intended for informational purposes only and cannot replace professional advice and qualified medical care. If you have the slightest suspicion that you have this disease, be sure to consult your doctor!

Tremor causes and treatment should be determined in a medical facility. It is a symptom of very serious diseases, with the exception of the consequences of alcohol, drugs, heavy physical work, and stress. Tremor is a rhythmic shaking in the fingers of the limbs.

Tremor causes, treatment, nature of origin:

Essential direction (unexplained nature of origin).

Dystonic.

Neuropathic in nature.

Psychogenic symptom.

Cerebellar.

"Rubral".

Parkinsonian in nature (Parkinson's disease).

Intentional.

Jitter localization:

Hands may shake.
Get your head involved.
Torso.
Very common chin trembling.

The jitter frequency is determined :

Low – up to 4 Hz.
Average – 4 – 7 Hz.
High – more than 7 Hz.

Divided into:

Action tremor (postural and kinetic)
Rest tremor.
In turn, kinetic is subdivided into (intentional, arising during certain actions).

Hand tremors causes physiological treatment:

Accompanied by symptoms of trembling voice, trembling chin, head, knees in patients of different age categories.

Occurs in normal people during times of stress.
Heavy stress on muscles during sports, strength training.
Various worries in life (speaking in the audience), switching to another problem or a walk, perhaps a mild sedative, will help.
Caffeine abuse.
During hunger.
It is observed in children of different ages, starting from birth. This happens due to a vulnerable, unformed nervous system. There is no treatment.
Disappears with age.

Please note that the trembling persists for two weeks; it is worth thinking about the pathological condition of its origin and be sure to undergo diagnostics.

Doctors' help is required if you have :

Trembling appeared when you started taking any new drug.
Intoxication with any chemical substances.
If you notice trembling for the first time and unexpectedly, or if an existing one has intensified.
Trembling interferes with your everyday life and disrupts social life.

Let's check how our hands shake :

Let's draw a spiral on a piece of paper. Is it not jagged? Then everything is fine.
A spiral with teeth on the edges? Trembling goes beyond physiology, you definitely need to be examined.

Start treatment after the examination, undergo diagnostics. Get a diagnosis so you don't waste precious time.
Typically, treatment is comprehensive, taking into account your diseases and symptoms.
In severe cases, only surgical intervention helps, there is no need to be afraid, you will live normally after.
In Parkinson's disease, tremors are virtually untreatable, but medications are needed to relieve symptoms.
Avoid stress in any form.
Stay away from problems, don't take everything to heart.
Learn to relax, master yoga.
Take sedatives (motherwort, peony, valerian, peppermint).
Give up coffee, drink not strong green tea.
Go to bed and get up at the same time of day.
Avoid alcohol and nicotine.
If your hands are trembling, take them with something heavy, this will help relieve the tremors.
All directions and treatment of the doctor (anti-sclerotic, vasodilating, sedative, anticonvulsant, as well as taking tranquilizers).
You cannot self-medicate if you have such a symptom; be sure to get examined.

Tremor treatment for essential cause (unexplained cause):

The symptom of postural and kinetic tremor, clearly visible in the fingers (often bilateral), has a hereditary cause.

Then symptoms of trembling of the torso, lips, legs, head, and vocal cords appear.

The function of writing a simple word on a piece of paper by patients is often impaired (the so-called writer's spasm). Increased arm tone and mild torticollis.

It is not observed at rest; as soon as the muscles are activated, it becomes active.
It usually starts with trembling on one side and eventually spreads to the other.
It also affects the muscles of the skull, causing head shaking.
Has a symmetrical distribution (arms, head).

Essential tremor cause:

Hereditary (manifests itself in adulthood and increases with the aging of the body.
There may be tremor (larynx, lower jaw, head).
It manifests itself as gradual symptoms (trembling of one hand, then spreading to other parts of the body and to both hands, even nodding movements appear).
The main difference is that Parkinson's trembling intensifies when you move (it does not threaten your health, does not require treatment, only for obvious reasons).

Essential tremor, prevention:

Live a healthy life.
Avoid alcohol, caffeine, and cigarettes.
Avoid stress.

Treatment of essential tremor:

Take non-selective adrenergic blockers (anaprilin).
Benzodiazepine medications (clonazepam).
Anticonvulsant medications (primidone, hexamidine).
Topiromats (Topomax).
Tranquilizers.
Botox injections.

Progression of essential tremor treatment:

A microstimulation procedure of the thalamus (brain) is performed:

An electrode is inserted into the thalamus and connected to an implanted stimulator in the patient’s chest area.
It removes all signals that arise in the brain that provoke tremor.

Causes of hand tremors:

There are many reasons why your hands are shaking, perhaps it is alcoholism or just nerves, among them:

Demoted.
You suffer from nervous disorders (neuropathy).
Increased function (hyperthyroidism).
Chronic kidney disease also leads to tremors.
Condition after a stroke.

The use of alcoholic beverages and drugs must be treated in medical institutions):

Vitamin therapy is prescribed.
Preparations containing magnesium.
Propranolol, primidone.
Harmful substances are removed from the body through detoxification.
Calcium antagonists.
Medicines to calm the nerves.
All kinds of head tumors.
The chronic disease multiple sclerosis also has these symptoms.
Anxiety and stress.
Encephalitis disease.
Various intoxications.
Serious traumatic brain injury.
Some genetic diseases (phenylketonuria).
Use of certain medications.

Intention (cerebellar) tremor cause:

The cerebellum of the brain is affected (very noticeable when moving, as well as when the patient tries to keep the limb motionless).
The tremor is not constant, sometimes on one side or both, and asymmetrical. The jitter becomes more noticeable if you want to do "hard work". If you relax your hands, the shaking stops.

Accompanied by:

Muscle tone decreases.
Movement control is impaired.
Constant fatigue occurs.

Risk factors:

Intoxication with drugs from the barbiturate group.
Traumatic brain injury.
Chronic diseases (multiple sclerosis).
Tumors.
Encephalitis.
Vascular processes.

Cerebellar tremor treatment :

Treatment with drugs is almost useless.
Sometimes relief comes in some cases with clonazepam and primidone.
An effective result is obtained when microstimulation of the thalamus is used.

Rhythmic myoclonus causes tremors:

Symptom of multiple sclerosis.
Brain pathology.
Wilson's disease.
Vascular diseases.

Manifestations:

Movements, sometimes sweeping arms and bodies.
Twitching in amplitude is achieved and reaches 1-2 centimeters.

Noticeable:

When the sick person tries to make any movement, everything goes away when the limb relaxes.
Sweeping movements are impossible with the hands; you have to press your hand or lie on it for the tremor to stop.

Rhythmic myoclonus treatment:

It consists of treating the patient’s underlying chronic disease.

A person gets enormous stress when having such a symptom; he always tries to hide his hands so that people around him do not notice.

Sometimes this symptom goes away on its own if it has a physiological form.

Watch the video, head tremor:

Its frequent repetition and increase indicates serious disorders in the body. Find the cause of the tremor and begin treatment; everything in life can be survived, but not death. I wish you a long and healthy life. Sincerely, Tatyana Nikolaevna,

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The most common type of involuntary muscle movement,tremor- These are regular rhythmic oscillations caused by the alternating contraction of opposing muscle groups.

Tremor is a typical symptom of cerebellar and extrapyramidal disorders, as well as a side effect of certain medications and drugs.

Main types of tremor:

Rest tremor. It occurs at rest, when a person does not take any action and is relaxed. This type of tremor is characteristic of Parkinson's disease.

Action tremor, or action tremor. Occurs when trying to make any movement. This type of tremor is characteristic of alcohol withdrawal syndrome.

Postural tremor. This type of tremor occurs when trying to maintain a certain posture or body position.

Possible causes of tremor:

1. Alcohol withdrawal syndrome. With severe dependence, in the first days without alcohol, patients may experience tremor of action. It occurs 6-8 hours after the last drink and gets worse quickly. Other early signs include: irritability, restlessness, insomnia, headaches, tachycardia, high blood pressure, nausea and vomiting. In severe cases, hallucinations, delusions, and seizures may occur.

2. Alkalosis – a change in blood pH towards the alkaline side. Severe alkalosis can cause severe movement tremors, muscle twitching, agitation, sweating, and hyperventilation. Patients may complain of dizziness, ringing in the ears and paresthesia (impaired sensitivity).

3. Benign familial essential tremor. This disease occurs in young people. It is characterized by bilateral tremor, which usually begins in the fingers and hands and can spread to the head, jaws, lips, and tongue. Involvement of the larynx causes the voice to tremble.

4. Cerebellar tumor. Action tremor is an important symptom of this disease. Other signs include ataxia, nystagmus, incoordination, muscle weakness and atrophy, and weakened or absent deep tendon reflexes.

5. General paresis. This condition may be a consequence of neurosyphilis and is accompanied by tremor of action. Other manifestations: ataxia, positive Babinski sign, dull headache.

6. Graves' disease. Symptoms of this disease include hand tremors, weight loss, weakness, heat intolerance, and shortness of breath. Also characterized by an enlarged thyroid gland (goiter) and exophthalmos (displacement of the eyeballs forward, “protrusion”).

7. Hypercapnia. An increase in the partial pressure of carbon dioxide (CO2) in the blood can cause the limbs to tremble when moving. Signs of increased CO2 levels include headache, blurred vision, weakness, drowsiness, and decreased level of consciousness.

8. Hypoglycemia – low blood sugar. In acute hypoglycemia, action tremor develops, accompanied by confusion, weakness, tachycardia, sweating, and cold, clammy skin. Early complaints usually include headache, extreme hunger, nervousness, double vision or blurred vision. As the condition worsens, the tremor may disappear, hypotension occurs, and consciousness is impaired.

9. Kwashiorkor. In the later stages of this disease, trembling may occur, both at rest and during large movements. Examination reveals myoclonus, rigidity of all extremities, hyperreflexia, swelling of the arms and legs, hair loss, dryness and flaking of the skin.

10. Multiple sclerosis is a severe, progressive neurodegenerative disease. Tremor when moving can appear and disappear - this is one of the early signs of the disease. Visual and sensory disturbances, nystagmus, muscle weakness, paralysis, spasms, hyperreflexia, impaired swallowing, and ataxia also occur. May cause constipation, frequent urination and urinary incontinence, and impotence.

11. Parkinson's disease. The classic sign of this degenerative disease is resting tremor. It usually starts in the fingers and affects the hands and feet, eyelids, jaw, lips, and tongue. Patients' hands tremble slowly and rhythmically. An attempt to cover the eyelids causes them to flutter.

The jaws may move up and down rhythmically. The protruding tongue can move back and forth in rhythm with other parts of the body. The frequency of the tremor remains constant, but its amplitude changes over time. Other characteristic signs: bradykinesia, disturbances in gait and posture, monotonous voice, mask-like face, difficulty swallowing, blepharospasm (the eyelids may close completely).

12. Porphyria. Involvement of the basal ganglia in porphyria can cause resting tremor, chorea, and muscle rigidity. As the disease progresses, generalized seizures with aphasia and hemiplegia occur.

13. Thalamic syndrome. Different types of thalamic syndrome can cause different combinations of tremors, profound sensory loss, and hemiataxia.

14. Thyrotoxicosis. Neuromuscular effects of this disease include action tremor, myoclonus, and hyperreflexia. Other signs of thyrotoxicosis: tachycardia, arrhythmias, anxiety, shortness of breath, sweating, heat intolerance, weight loss due to increased appetite, diarrhea. There is an enlarged thyroid gland and exophthalmos.

15. Wernicke's encephalitis is a disease that occurs due to a deficiency of vitamin B1 (thiamine), mainly in alcoholics. Causes tremors when moving. Other signs of the disease: apathy, ataxia, nystagmus, orthostatic hypotension, tachycardia, confusion and others.

16. West Nile encephalitis. This viral infection is characteristic of Africa and the Middle East and is transmitted by local mosquito bites. Cases of the disease are also observed among tourists. Mild infections include fever, headache and muscle pain, usually accompanied by a rash and swollen lymph nodes. In severe forms of the disease, the fever is high, stiffness of the neck muscles, disorientation, stupor, coma, tremors, seizures and paralysis occur. Sometimes leads to death.

17. Wilson's disease is a disorder of copper metabolism in the body. Tremor in Wilson's disease occurs early and progresses as the disease progresses. A characteristic sign of the disease is Kayser-Fleischner rings on the cornea. Other signs: incoordination, chorea, ataxia, muscle spasms and rigidity, weakness, personality disorder, seizures, hypotension. Jaundice, hyperpigmentation (bronze skin), enlarged liver and spleen, and ascites may occur.

18. Medicines. Phenothiazines (Fluphenazine) and other antipsychotics may cause tremors at rest. Metoclopramide and metyrosine also sometimes cause tremors. Intoxication with large doses of lithium, terbutaline, pseudoephedrine, amphetamines and phenytoin causes tremors, which disappear when the dose is reduced.

19. Medicinal plants. Herbal materials containing ephedrine (ma huang and other types of ephedra) can cause a variety of cardiovascular and nervous system side effects, including tremors.

20. Manganese poisoning. Early signs of manganese poisoning: resting tremor, chorea, amnesia, personality changes, mask-like face.

21. Mercury poisoning. Chronic mercury poisoning is characterized by irritability, excess saliva, tooth loss, gum disease, slurred speech and tremors.

22. Tremor in newborns may have specific pediatric causes, including cerebral palsy, fetal alcohol syndrome, and maternal drug use during pregnancy.

: Master of Pharmacy and professional medical translator

Trembling (tremor)- hyperkinesis of the limbs, lower jaw, trunk and head, characterized by rhythm and small amplitude of vibrations.
Based on the number of vibrations per second, tremor is divided into slow (2-5 vibrations) and fast (6-10 vibrations).

Most often observed:

at Parkinson's disease,
essential tremor,
hepatolenticular degeneration,
lipidoses,
cerebral
when overworked,
intoxications (alcohol, mercury, antipsychotics, sodium valproate),
somatic diseases ().

Static tremor - trembling at complete rest.
Postural tremor - trembling when giving a limb any pose (lat. postur - pose), most often stretching the arms forward.
Intention tremor (lat.intendo - strain)- tremor; arising during active innervation of the limbs, purposeful actions (see table).
Liver tremor - a special (and frequent) variant of tremor .

Differential diagnosis of tremor.

Tremor	Occurrence situation	Characteristic	Treatment
Essential; physiological	Rest, movement; intensifies with emotional influences	Frequency 6-12 in 1 s. Upper limbs and head	Anaprilin, diazepam
Intentional	Appears or worsens with movement	3-5 in 1 s; upper limbs
Peace	Peace; intensifies with emotional influences	3-7 in 1 s (usually 6). Limbs and head; characteristic feature - “rolling pills>	Dopamine agonists: nacom, madopar, parlodel. Anticholinergics: cyclodol
Metabolic	Symptoms of the underlying disease (thyrotoxicosis, hepatic encephalopathy)	10-20 in 1 s. Upper limbs and head	Correction of metabolic state
Alcohol withdrawal	Appears 8-12 hours after the last drink	6-10 in 1 s. Limbs and head	Chlordiazepoxide, diazepam

Phenomenologically, “rest tremor” in a purely clinical sense is characteristic of parkinsonism, essential tremor, various toxicoses (alcoholism, antipsychotics, antidepressants, heavy metals), hepatocerebral dystrophy, and psychogenic disorders.

TREATMENT.

Treatment of the underlying disease.
Have a pronounced symptomatic effect on tremor beta-blockers (anaprilin, obzidan).