Tremor

Tremor

Tremor is hyperkinesis, manifested by involuntary rhythmic oscillatory movements of the whole body or its parts as a result of repeated contractions and relaxation of muscles.

Classification

• • Depending on the frequency of oscillatory movements: slow (3-5 Hz) and fast (6-12 Hz) tremor
  • By the nature of the movements: for example, a tremor like yes-yes, no-no, like rolling pills, counting coins
  • Depending on the part of the body involved: tremor of the hands, feet, tongue
  • Depending on the moment of occurrence
  • Static (rest tremor)
  • Dynamic (kinetic, intentional; occurs during muscle activity)
  • Mixed (appears at rest and on movement)
  • Postural (while maintaining posture)
  • Depending on the reasons
  • Emotional
  • Senile
  • Hysterical
  • essential
  • parkinsonian
  • With lesions of the cerebellum
  • Alcoholic
  • Mercury
  • With thyrotoxicosis. Genetic aspects – see Appendix 2. Hereditary diseases: mapped phenotypes

Etiology and clinical picture

• • The etiology and clinical picture of essential and parkinsonian tremor are discussed in the relevant articles.
  • Physiological tremor – a slight rapid tremor of the fingers, eyelids, sometimes the head, occurs and intensifies with muscle tension, fatigue, cooling or emotional arousal
  • Senile (senile) tremor – mixed trembling of the head, lower jaw, fingers, does not significantly affect the performance of movements
  • Tremor caused by drugs – tremor can cause phosphodiesterase inhibitors (including caffeine), B-adrenergic agonists, glucocorticoids
  • Mercury tremor – occurs at rest and intensifies with voluntary movements, manifests itself in the muscles of the face, then the limbs; observed with mercury intoxication
  • Alcohol tremor – trembling of the spread fingers of outstretched hands, as well as the muscles of the face and tongue, is observed in acute alcohol intoxication, alcoholism and withdrawal syndrome
  • Hysterical tremor – is permanent or paroxysmal in nature, with an unstable rhythm and amplitude, increases under the influence of psychogenic factors; observed in hysteria
  • Chill-like tremor – tremor of the whole body, accompanied by contraction of the muscles that raise the hair, and blanching of the skin
  • Tremor in lesions of the cerebellum – intentional tremor, manifested in the rhythmic vibrations of the limb as it approaches the intended target, the tremor can be postural – traditionally rough, occurs when maintaining a certain posture or holding gravity. Titubation is a type of postural tremor that appears in the vertical position of the body and disappears in the horizontal position.

Treatment:

• • With essential tremor – see Essential tremor
  • Adequate therapy of the underlying disease
  • At

tremor due to chronic anxiety – benzodiazepine tranquilizers (diazepam 2-10 mg, lorazepam 1-2.5 mg, oxazepam 10-30 mg 3-4 r / day)

• • For acute anxiety, tremor associated with the use of drugs, and essential tremor – propranolol (anaprilin) ​​20-80 mg 4 r / day (if it is ineffective or intolerant – primidone 50-250 mg 3 r / day)
  • exercise therapy
  • Additional rest.

Synonym. jitter

See also Essay tremor. Parkinsonism, Parkinson’s disease, Drug parkinsonism, Alcoholism, Hyperthyroidism, Poisoning with mercury and its compounds

ICD

• G25.0 Essential tremor
• 025.1 Drug-induced tremor
• G25.2 Other specified tremors
• R25.1 Tremor, unspecified