Tremor
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Tremor is a
rhythmic, involuntary muscular contraction characterized by
oscillations (to-and-fro movements) of a part of the body. The most
common of all involuntary movements, tremor can affect various body
parts such as the hands, head, facial structures, vocal cords,
trunk, and legs; most tremors, however, occur in the hands. Tremor
often accompanies neurological disorders associated with aging.
Although the disorder is not life-threatening, it can be responsible
for functional disability and social embarrassment.
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There are many types of tremor and several ways in
which tremor is classified. The most common classification is by
behavioral context or position. There are five categories of tremor
within this classification: resting, postural, kinetic,
task-specific, and psychogenic.
Resting or
static
tremor occurs when the muscle is at rest, for example when the
hands are lying on the lap. This type of tremor is often seen in
patients with Parkinson’s disease.
Postural tremor occurs
when a patient attempts to maintain posture, such as holding the
hands outstretched. Postural tremors include physiological tremor,
essential tremor, tremor with basal ganglia disease (also seen in
patients with Parkinson’s disease), cerebellar postural tremor,
tremor with peripheral neuropathy, post-traumatic tremor, and
alcoholic tremor.
Kinetic or intention (action) tremor
occurs during purposeful movement, for example during finger-to-nose
testing.
Task-specific tremor appears when performing
goal-oriented tasks such as handwriting, speaking, or standing. This
group consists of primary writing tremor, vocal tremor, and
orthostatic tremor.
Psychogenic tremor occurs in both older
and younger patients. The key feature of this tremor is that it
dramatically lessens or disappears when the patient is distracted.
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There are some treatment options available for
tremor; the appropriate treatment depends on accurate diagnosis of
the cause. Some tremors respond to treatment of the underlying
condition, for example in some cases of psychogenic tremor treating
the patient’s underlying mental problem may cause the tremor to
disappear. Also, patients with tremor due to Parkinson’s disease may
be treated with Levodopa drug therapy. Symptomatic drug therapy is
available for several other tremors as well. For those cases of
tremor in which there is no effective drug treatment, physical
measures such as teaching the patient to brace the affected limb
during the tremor are sometimes useful. Surgical intervention such
as thalamotomy or deep brain stimulation may be useful in certain
cases.
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NINDS investigators are currently conducting
physiological studies of patients with tremors. These studies
include classifying the tremor and providing appropriate therapy.
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International Essential Tremor
Foundation
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