We constantly use our hands. Every morning, millions of people take a shower, brush their teeth, shave, dress, and have 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 a lot.
General information about the disease
Essential tremor is a genetic neurological disorder in which vigorous uncontrolled oscillatory movements of various parts of the body occur. Usually they occur with movement and muscle tension. Most often, essential hand tremor occurs. Trembling is observed when performing the simplest actions: tying shoelaces, shaving, writing text.
Tremor can also occur in other parts of the body, such as:
- Head.
- Chin.
- Vocal cords.
- Legs.
This common hereditary disorder for most people at first brings minor inconvenience, which over time can change for the worse. In the most severe cases with essential tremor, there is a complete loss of working capacity of the affected parts of the body.
Each person may experience a slight tremor when performing daily activities. For example, your hands will tremble slightly if you hold them in front of you. This is a normal physiological tremor. In older people, this pathology may be a little more noticeable if they are very excited or worried about something.
Also, tremors can occur when taking certain types of drugs and methods of therapy, for example, when using inhalers to treat asthma.
Features
Essential tremor begins gradually, usually in one or both hands. Emotional stress, fatigue, caffeine, and fever can make the condition worse. Essential tremor has the following features that distinguish it from other diseases associated with tremors:
- Occurs with movement or stress.
- It does not cause other diseases or problems, for example, stoop, shuffling gait, insecure, slow motion.
- Acts on limbs, head and voice.
Essential tremor worsens over the years. In the end, it can become so strong that tying shoelaces, drinking a glass of water or writing a letter will be almost impossible.
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 ailment.
Symptoms
The only symptom of essential tremor is the characteristic movements that occur with tension or nervous excitement. At rest, trembling does not manifest itself. As a rule, tremor affects both sides of the body equally.
The following factors can aggravate the condition, increase the frequency and intensity of tremors:
- Stress.
- Anxiety.
- Anger.
- Physical labor.
- Caffeine (found in black tea, coffee).
- Insomnia.
- Some medications.
Varieties
Essential hand tremor manifests itself most often. First, one hand starts to tremble, and after 1-2 years - the second.
Essential tremor of the head is expressed in fluctuations in the vertical and horizontal directions. Basically, this type of disease affects women.
Vocal cord tremor in most cases occurs in older people. It is expressed in periodic rhythmic fluctuations in tonality or volume when pronouncing vowels. Medicines that are prescribed to reduce trembling of the limbs are usually not as effective for the vocal cords.
Leg tremors are very rare.
Causes
Tremors in various parts of the body can begin at any age, starting in 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 of essential tremor, are at great risk of inheriting this condition. Familial forms of the disease often manifest at an early age.
Studies show that in some people, essential tremor can be caused by an unknown mutation in one of the genes. But, unfortunately, there are no diagnostic methods to determine whether a disease is caused by one specific defective gene or several.
Other causes of tremor
There are a number of other factors and diseases, one of which may be tremors. These include:
- Hyperthyroidism (hyperthyroidism) is a condition in which the thyroid gland malfunctions. Excess hormones accelerate the body. There is anxiety, nervousness, fatigue, and insomnia. As a result, tremors may appear.
- Parkinson's disease is a chronic disease that causes changes in the central nervous system. Most often, both upper and lower limbs suffer. Tremor does not stop during rest.
- Multiple sclerosis is a disease in which damage to the brain and spinal cord occurs. The occurrence of tremor occurs due to the destruction of the nerve pathways responsible for coordination. Distinguish trembling in a sitting position, standing, with movement and tremor of eyeballs.
- Dystonia is a syndrome that causes a number of motor disorders. It is expressed in involuntary muscle spasms.
- Stroke is a violation of cerebral circulation, 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, such as aerosols for asthma, antidepressants. One side effect is tremor.
- Caffeine abuse. Coffee is a stimulant. Perhaps the appearance of trembling in the hands or other parts of the body due to impaired functions of the nervous system, narrowing of blood vessels, increased heart rate, increased pressure.
Diagnostics
The diagnosis consists of collecting an anamnesis: questioning the patient, examination, determining the possible causes of tremor. For this, the doctor may prescribe additional studies, such as:
- Computed tomography (CT) of the brain - a scan performed using x-ray radiation. It is used to obtain detailed images of internal organs, blood vessels, bones, various formations.
- Magnetic resonance imaging (MRI) - examination using a magnetic field and radio waves, aimed at obtaining images of internal organs.
- Analysis of urine.
- Blood analysis.
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 allows you to measure the performance of muscles and nerves. Electromyography provides information on how well muscles are able to respond during nerve stimulation. Lack of response indicates nerve damage.
Also, special tests are performed to diagnose essential tremor. The patient is invited to perform the following actions:
- Draw a continuous line, spiral.
- Write a few words.
- Reach the tip of the nose with your finger.
Treatment
Most people turn to a specialist when trembling limbs or other parts of the body begin to disrupt their quality of life. Unfortunately, there is currently no cure for essential tremor. Therefore, the treatment of essential tremor is aimed at maximizing the relief of symptoms, that is, reducing involuntary tremors. I must say that modern drugs and techniques can achieve excellent results, especially at the very beginning of the disease.
Minor tremor
If the manifestations of the disease are minor, 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 voice trembling . Also, factors provoking deterioration should be avoided. This is the use of caffeine, alcohol, stress and lack of sleep.
Moderate tremor
With a moderate manifestation of essential tremor, a specialist can prescribe the following drugs:
- Beta blockers designed to treat hypertension (high blood pressure).
- Anticonvulsants used to treat epilepsy. They are prescribed when beta-blockers do not help relieve symptoms.
- Sedatives are used in situations where trembling is caused by stress and anxiety.
- Botox injections. With tremor of the head, injections into the cervical muscle are prescribed. The effectiveness of this method occurs after 3 months.
Intense tremor
With severe symptoms, surgical treatment can be considered. In these cases, the patient has no reaction to medications. There are two types of operations:
- Deep brain stimulation.
- Thalamotomy.
Deep brain stimulation
This procedure involves placing electrodes in the brain. Thin wires go from them to the pulse generator (a device similar to a pacemaker), which is implanted under the skin of the chest. The generator produces an electric current that helps regulate brain waves and control tremors.
Studies have shown that deep brain stimulation can reduce tremor by about 90%. It is worth noting that, like any other operation, deep brain stimulation is associated with risk. Possible side effects:
- Speech problems.
- Brain hemorrhage.
- Stroke.
- Complications of anesthesia.
- Unpleasant sensations in the form of 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 regulating the level of stimulation.
Stereotactic thalamotomy
This is the name of the operation aimed at the destruction of 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, and the risk of a stroke.
Thalamotomies are often preferred to deep brain stimulation because of the possibility of reducing adverse reactions.
It should be remembered, because of the possible risks associated with brain surgery, an operation is performed only when other methods do not help.
Alternative methods and prevention
To reduce the intensity of the manifestations of the disease, essential tremor there are other ways:
- Exclusion of caffeinated foods from the diet.
- Reduce or eliminate alcohol consumption. Sometimes people notice a slight improvement after drinking alcohol. But tremor, as a rule, only worsens over time. In addition, increasing the dose needed to stop 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 methods, such as massage or meditation.
- Change your lifestyle. If possible, try not to aggravate the condition: less often write, not do physical work, use voice control.
- Get enough sleep and rest. A good long sleep not only replenishes the body, but also helps reduce tremor.
- For hand tremors, use heavier utensils, cutlery, write with thick pens, pencils, use weighting agents on the wrists.
- 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, soothe 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. Alcohol tinctures also help. Here are some recipes:
1. Pour 50 mg of propolis with high-quality vodka (500 ml) and insist in a place inaccessible to the light for 15 days. Strain. Take three times a day in a tablespoon 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 this mixture 50 grams, pour into a glass container, pour vodka (500 ml). The product should be infused for 21 days out of the reach of children and light. Strain. Drink a teaspoon three times a day.