Shaking hands (tremor)
Hand tremor is one of the common hand function symptoms. People usually associate it with Parkinson's disease, but is hand tremor necessarily Parkinson's disease?
Hand tremor, medically known as hand tremor, is a symptom of involuntary movement of the hand. It mainly manifests as involuntary, voluntary rhythmic trembling or shaking of the hand, which is caused by the alternating contraction of the agonist muscle and the antagonist muscle.
In fact, tremor and Parkinson's disease are not equal. Tremor can be divided into three categories: physiological, functional and pathological. Their characteristics are shown in the table below.
Due to reduced physiological functions and physiological brain atrophy, the elderly may experience subtle tremors without intervention.
Functional tremor is mostly related to mental factors. Emotional tension, excessive pressure, depression, anxiety and other factors may cause hand tremor. The tremor will reduce or disappear after the stimulating factors are removed. But if triggering factors persist, symptoms may worsen or even become permanent.
Resting tremor is mainly seen in Parkinson's disease. It manifests as involuntary ball-like movements of the hands at rest. The tremor is reduced during exercise. Monitoring electromyography can show a rhythmic tremor of 4~6Hz; generally, this kind of resting tremor It progresses in an N-shaped pattern, gradually extending from one upper limb to one lower limb, then to the contralateral upper limb and contralateral lower limb.
Symptoms of Parkinson's disease include resting tremor, muscle stiffness and bradykinesia.
Kinetic tremor
Kinetic tremor mainly manifests as excessive or insufficient movement and loss of movement stability, especially when starting, stopping, and changing directions are more difficult. Also called ataxic tremor, intention tremor or action tremor, it is more common in patients with cerebellar lesions and cerebellar injuries.
postural tremor
Postural tremor is mainly seen in the disease of essential tremor, which often has a family history of inheritance. The tremor is obvious when the hands are active, and decreases or disappears when standing still or drinking alcohol. It may also be accompanied by involuntary tremors of the head, which is mostly a chronic progression. Dystonia can also manifest as postural tremor of the hands, but is often accompanied by segmental and regional involuntary movements of other parts of the body.
convulsive tremor
Convulsive tremor is mainly seen in secondary epilepsy, which mainly manifests as rhythmic twitching of one upper limb or hand, with sudden and sudden stops, and sometimes spreads to the ipsilateral lower limb (secondary generalized convulsive seizure). Some patients are accompanied by post-convulsive convulsions. Limb weakness and frequent recurrence of symptoms. Magnetic resonance imaging examinations usually reveal organic lesions, such as cortical dysplasia or low-grade tumors. EEG examinations show epileptiform discharges.
In addition, hand tremor can also be caused by drugs, which is called drug-induced tremor. It is generally related to age factors. As age increases, the speed and ability to metabolize drugs decreases. Therefore, it is more common in older people than in younger people.
The most common drugs that cause tremor are: gastromotility drugs, such as metoclopramide; antipsychotic drugs, such as chlorpromazine, perphenazine, haloperidol, etc.; antidepressants; antiepileptic drugs; antihypertensive drugs medicine; antibiotics, etc.
