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November 10, 2011
Tremor – an illness which characteristic symptoms is manifestation of involuntary fluctuations of a certain part of a body. Such fluctuations provoke alternating or synchronous reductions of the reciprocal innervated muscles. The tremor can be shown practically in any part of a body, but generally at patients the tremor in the head and a tremor of hands is observed. At the same time at the person the voice begins to shiver, and it is in some cases shown tryaseny trunks and a foot.
As one of the most often shown types of a tremor it is considered to be an essential tremor today. This disease can be diagnosed for several family members. The tremor of hands when the patient lifts a certain subject is swept especially up or raises a hand, indicating something. However during directly movement the tremor is not observed.
Certain diseases (liver failure, poisoning with lithium, mercury, arsenic), and also the medicines directly influencing a condition of a nervous system (for example, antidepressants) can become the reasons of this disease. The tremor and as a by-effect after reception of a number of drugs is shown.
Types and symptoms of a tremor
Today specialists distinguish several types of a tremor. A tremor high-quality — the most widely arising frustration of motive system. Such disease sometimes proceeds rather hard. It is generally shown at teenagers and young men. As a rule, its first manifestation – a tremor of hands: at first one, later – both. Most of all trembling is noticeable at the hands extended forward. Further there is a tremor of other parts of a body, and at manifestation of a tremor of a throat and language there can be speech difficulties. Its manifestations are aggravated during a stress, and also after alcohol acceptance.
The tremor postural – this type of an illness can be a hereditary illness, and also result of high uneasiness, existence of hyperfunction of a thyroid gland. Also the abstinence syndrome after alcohol intake or drugs can be the reason of this type of a tremor. One more reason of manifestation of this type of a tremor – poisoning with chemical compounds or overdose of certain drugs. This type of a tremor is characterized by a melkorazmashistost therefore its manifestations at outstretched arms and thumbs up of the patient are most noticeable. At the same time during the movement the tremor does not disappear, and at a strong concentration of the patient his symptoms increase.
The tremor intentsionny arises after damage of a cerebellum which bears responsibility for deduction of balance during walking. Are characteristic of such patients krupnorazmashisty and a little rough to the movements, shown during purposeful movements and absent at rest. If the patient tries, having closed eyes, in a pose standing with outstretched arms to reach a nose, not go it will not turn out.
Asteriksis – the most dangerous kind of this disease. This kind of a tremor arises owing to Wilson-Konovalov's illness, liver, renal, respiratory failure, existence of defeats of a mesencephalon. Very slow and spasmodic bendings of hands and legs are characteristic for this purpose like a tremor.
The tremor is the main symptom of an illness of Parkinson. As a rule, this illness develops at people of advanced age, the tremor of hands is an initial symptom of this illness. Parkinson's illness it is frequent to become the disability reason, however he does not influence life expectancy at all.
Diagnosis of a tremor
To diagnose a tremor, it is important to define a disease which is the cornerstone of manifestation of a tremor. For diagnosis of a tremor the specialist first of all defines his localization, features of distribution of a tremor, pays attention to characteristic topographical features (so, only the tremor of one finger, symmetry or asymmetry of trembling sometimes can be shown).
At statement of the diagnosis amplitude-frequency characteristics, as far as the movements are expressed, features of manifestation of a tremor and the loudspeaker in the subsequent are considered.
The specialist carries out also the description of the diseases taking place which became a background for trembling manifestation.
For diagnosis video filming by the slow motion method is carried out - it is shooting with high frequency and delay of a projection of personnel. The patient is investigated by means of a tremograf which can register trembling in three planes, with use of the dark photo (fixing of an extremity on the certain segments participating in trembling is carried out). The method of an electromyography allows to define the quantitative and qualitative characteristic of rhythmic hyperkinesias.
Treatment of a tremor
At manifestation of a high-quality tremor of treatment of an illness generally it is not required. If trembling of parts of a body is expressed very strongly, then to the patient drugs propranolol or Primidonum can be appointed. In case of manifestation of a tremor only at an emotional pressure, the single dose of the drugs having sleeping pill and the calming effect, for example, of lorazepam is appointed.
At an essential tremor complex treatment by drugs — antagonists of beta adrenoceptors, benzodiazepines and Primidonum is appointed. By means of beta adrenoblockers it is possible to lower amplitude of a tremor and to considerably improve a clinical picture. Manifestations of an essential tremor also decrease after reception of benzodiazepines. However at purpose of treatment it should be taken into account that owing to the continuous use of the mentioned drugs tolerance can develop. Therefore they are used not constantly, and in case of need. Sometimes alcohol is applied to reduction of symptoms of a tremor, however there is a risk of its abuse. As therapy of this type of a tremor appoint Primidonum in a dose of 25-250 mg/days. Its combination with beta adrenoblockers is also possible.
Treatment of a cerebellar tremor, as a rule, has no due effect. However, there is information on positive results after therapy by clonazepam and Primidonum. Microstimulation of a thalamus or a stereotaxic talamotomiya gives more expressed effect.
Parkinson's illness is considered an incurable illness today. However timely and correct therapies can suspend a course of a disease of Parkinson considerably. So, the patient is recommended to use a cane constantly. During the lowering of working capacity and disturbance of skills in life administration of drug levodof can be appointed.
For effective treatment of a tremor it is important to make observation and to define what circumstances become the reason of its manifestation. In some cases the positive effect manages to be reached after decrease in influence on the patient of factors of a stress. The tremor of hands can be reduced by means of continuous carrying a heavy bracelet or hours.
Prevention of a tremor
For prevention of a tremor it is necessary to avoid stressful situations. It is important to watch that the patient did not have a feeling of fatigue aggravating a state. As a rule, it aggravates a condition of the patient with a tremor.
It is necessary to use as little as possible products and the drinks containing caffeine and to refuse completely smoking. Also effective preventive measure is regular performance of physical exercises.