We use our hands all the time. Every morning, millions of people shower, brush their teeth, shave, get dressed, eat breakfast. These actions are incredibly difficult to do without hands. However, about 10 million people cannot cope with such simple tasks, but they have hands, only they tremble violently.
General information about the disease
Essential tremor is a genetic neurological disorder that causes vigorous uncontrolled oscillatory movements of various parts of the body. They usually occur during movement and muscle tension. The most common is essential hand tremor. Trembling is observed when performing the simplest activities: tying shoelaces, shaving, writing text.
Tremors can also occur in other parts of the body, such as:
- Head.
- Chin.
- Voice cords.
- Legs.
This common hereditary disorder for most people causes minor discomfort at first, which can change for the worse over timeside. In the most severe cases, with essential tremor, there is a complete loss of efficiency of the affected parts of the body.
Everyone can experience a slight tremor while performing daily activities. For example, hands will tremble slightly if held in front of you. This is a normal physiological tremor. In older people, this pathology may be slightly more noticeable if they are very aroused or anxious about something.
Tremors can also occur with certain medications and therapies, such as asthma inhalers.
Features
Essential tremor starts gradually, usually in one or both hands. Emotional stress, fatigue, caffeine, and fever can aggravate the condition. Essential tremor has the following features that distinguish it from other tremor-related disorders:
- Occurs when moving or exerting.
- Does not cause other diseases or problems, such as slouching, shuffling, unsteady, slow movements.
- Affects limbs, head and voice.
Essential tremor worsens over the years. Eventually, it can become so strong that it becomes almost impossible to tie your shoelaces, drink a glass of water, or write a letter.
Essential tremor affects men and women equally. The disease can affect people of any age, but is usually more common in the elderly. About 4 out of 100% of adults over 40 suffer from this condition.
Symptoms
The only symptom of essential tremor is the characteristic movement that occurs with tension or nervous excitement. At rest, trembling does not manifest itself in any way. Typically, tremors affect both sides of the body equally.
The following factors can worsen the condition, increase the frequency and intensity of trembling:
- Stress.
- Alarm.
- Anger.
- Physical work.
- Caffeine (found in black tea, coffee).
- Insomnia.
- Some drugs.
Varieties
Essential hand tremor is the most common. First, one hand begins to tremble, and after 1-2 years - the second.
Essential tremor of the head is expressed in fluctuations in the vertical and horizontal directions. Mostly women suffer from this type of disease.
Tremor of the vocal cords in most cases occurs in the elderly. It is expressed in periodic rhythmic fluctuations in tonality or volume during the pronunciation of vowel sounds. Medicines prescribed to reduce trembling tend to be less effective on the vocal cords.
Tremor of the legs is very rare.
Reasons
Trembling in various parts of the body can begin at any age, starting from childhood. The exact causes of essential tremor are still unknown. In 50% of cases, the disease is inherited. Children, even one of whose parents has a history ofessential tremor are at high risk of inheriting the condition. Familial forms of the disease often appear at an early age.
Studies show that in some people essential tremor may be caused by an unknown mutation in one of the genes. But, unfortunately, there are no diagnostic methods to determine whether the disease is caused by one specific defective gene or several.
Other causes of tremors
There are a number of other factors and diseases, one of the symptoms of which may be tremor. These include:
- Hyperthyroidism (hyperthyroidism) is a condition in which the thyroid gland malfunctions. An excess of hormones speeds up the work of the body. There is anxiety, nervousness, fatigue, insomnia. As a result, a tremor may appear.
- Parkinson's disease is a chronic disease that causes changes in the central nervous system. Both the upper and lower extremities are most commonly affected. Tremor does not stop during rest.
- Multiple sclerosis is a disease that affects the brain and spinal cord. The occurrence of tremor occurs due to the destruction of the nerve pathways responsible for coordination. Distinguish between trembling while sitting, standing, moving and tremor of the eyeballs.
- Dystonia is a syndrome that causes a range of movement disorders. Expressed as involuntary muscle spasms.
- Stroke is a cerebrovascular accident, in which, in rare cases, tremors can occur.
- Peripheral neuropathy- damage to peripheral nerves. Hand tremors usually occur.
- Symptom of withdrawal of alcohol, drugs.
- Medications, eg asthma sprays, antidepressants. One of the side effects is tremor.
- Caffeine abuse. Coffee is a stimulant. There may be trembling in the hands or other parts of the body due to dysfunction of the nervous system, vasoconstriction, increased heart rate, increased pressure.
Diagnosis
The diagnosis consists in taking an anamnesis: questioning the patient, examining, determining the possible causes of tremor. To do this, the doctor may prescribe additional studies, such as:
Computed tomography (CT) of the brain is a scan performed using x-rays. Used to obtain detailed images of internal organs, blood vessels, bones, various formations
- Magnetic resonance imaging (MRI) is an examination using a magnetic field and radio waves to take pictures of internal organs.
- Urine analysis.
- Blood test.
In some cases, electromyography (EMG) may be required to check the electrical activity of the muscles. Electromyography is a test that is performed by inserting a thin needle into the muscles, which measures the performance of the muscles and nerves. Electromyography provides information about how well the muscles are able to respond during nerve stimulation. Lack of response indicates nerve damage.
Also, special tests are carried out to diagnose essential tremor. The patient is asked to do the following:
- Draw a continuous line, a spiral.
- Write a few words.
- Reach your finger to the tip of your nose.
Treatment
Most people turn to a specialist when trembling of the limbs or other parts of the body begins to interfere with their quality of life. Unfortunately, there is currently no cure for essential tremor. Therefore, the treatment of essential tremor is aimed at the maximum relief of symptoms, that is, the reduction of involuntary trembling. It must be said that modern drugs and techniques allow achieving excellent results, especially at the very beginning of the disease.
Minor tremor
If the manifestations of the disease are mild, treatment of essential tremor is not required. Physical therapy in some patients can improve muscle control and coordination in the arms and legs. And speech - to alleviate the symptoms of mild trembling of the voice. It is also worth avoiding factors that provoke deterioration. These are caffeine, alcohol, stress and lack of sleep.
Moderate tremor
For moderate manifestation of essential tremor, the specialist may prescribe the following drugs:
- Beta-blockers designed to treat hypertension (high blood pressure).
- Anticonvulsants used to treat epilepsy. They are assigned towhen beta-blockers fail to relieve symptoms.
- Sedative drugs are used in situations where flinching is caused by stress, anxiety.
- Botox injections. With a tremor of the head, injections are prescribed in the neck muscle. The effectiveness of this method comes after 3 months.
Intense tremor
Surgical treatment may be considered for severe symptoms. In these cases, the patient does not respond to medications. There are two types of transactions:
- Deep Brain Stimulation.
- Thalamotomy.
Deep Brain Stimulation
This procedure involves placing electrodes in the brain. Thin wires run from them to a pulse generator (a device similar to a pacemaker), which is implanted under the skin of the chest. The generator produces an electrical current that helps regulate brain waves and control tremors.
Studies have shown that deep brain stimulation can reduce tremors by about 90%. It is worth noting that, like any other operation, deep brain stimulation is associated with risks. Possible side effects:
- Speech problems.
- Brain hemorrhage.
- Stroke.
- Complications from anesthesia.
- Unpleasant tingling sensations.
Despite a number of side effects, recent studies have shown that deep brain stimulation is a relatively safe procedure. Some side effects can be eliminated by adjusting the level of stimulation.
Stereotactic thalamotomy
This is the name of an operation aimed at destroying certain areas of the brain. The technique is quite effective. But it should be noted that this operation also has a number of side effects, such as difficulty swallowing, speech impairment, the risk of stroke.
Deep brain stimulation is often preferred over thalamotomies due to the potential for reducing adverse reactions.
Be aware that due to the potential risks associated with brain surgery, surgery is only performed when other methods fail.
Alternative methods and prevention
There are other ways to reduce the intensity of the manifestations of the disease essential tremor:
- No caffeinated foods.
- Reduce or eliminate alcohol. Sometimes people notice some improvement after drinking alcoholic beverages. But tremors tend to get worse over time. In addition, increasing the dose needed to stop the tremor can lead to alcoholism.
- Learn to relax. Stress and anxiety worsen the condition of patients with essential tremor. It is impossible to completely avoid negative emotions, but you should learn how to properly respond to stressful situations. For example, practice various relaxation techniques such as massage or meditation.
- Change your lifestyle. Try not to if possibleaggravate the condition: write less often, do not do physical work, use voice control.
- Sleep and rest. A good long sleep not only replenishes the body's strength, but also helps to reduce tremors.
- For hand tremors, use heavier dishes, cutlery, write with thick pens, pencils, use wrist weights.
- Use folk remedies to improve the condition with essential tremor. Herbs contain active ingredients that improve the functioning of the nervous system, slow down the activity of brain cells, calm and relax. The patient can drink teas and infusions of chamomile, valerian, lemon balm, lavender; take relaxing baths with passionflower, venus slipper, chamomile, lavender; sleep on a pillow of dried plants. Alcoholic tinctures also help well. Here are some recipes:
1. Pour 50 mg of propolis with high-quality vodka (500 ml) and insist in a place inaccessible to light for 15 days. Strain. Take three tablespoons daily with clean water.
2. Take in equal parts dry crushed raw materials: rosehip roots, cyanosis, St. John's wort, motherwort, rosemary, mint, lemon balm, hop cones. Mix. Take 50 grams of this mixture, pour it into a glass container, pour vodka (500 ml). The remedy should be infused for 21 days in a place inaccessible to children and light. Strain. Drink a teaspoon three times a day.
