Essential tremor

Essential tremor is indicated by different species. It can be congenital, benign, family, hereditary or idiopathic. It is considered the most common extrapyramidal disease, accompanied by postural-kinetic tremor. Despite the fact that the disease is benign, it is often the cause of significant functional and social maladjustment.

Essential tremor is equally common in both men and women. As a rule, its first manifestations are observed in middle age. However, there are cases of its occurrence at an early age.

The formation of tremors is presumably carried out by two main mechanisms: the presence of peripheral and central oscillations (oscillations). Central oscillations occur in the unifying cerebellar cores, lower olives and the site of the red core system.

Peripheral oscillations are carried out by means of sensitive peripheral endings inducing (radiating) motor modulations. In this case, the connecting element of the peripheral and central system is the pyramidal tract.

Hereditary essential tremor is manifested by a symmetrical, bilateral postural-kinetic tremor (trembling) of the hands. In rare cases asymmetric tremor is observed.

The first manifestations of tremors are of a periodic nature, they occur during overwork or agitation. Over time, the tremor becomes constant, progressing throughout life. At the same time with age, there may be a slight decrease in the jitter frequency, and an increase in its amplitude. With increasing frequency, patients experience significant difficulties in eating, dressing, writing, and so on. As practice shows, an essential tremor in fifteen to twenty percent of cases leads to disability.

Essential tremor is most pronounced in the hands (their distal sections). In a number of cases, it appears in the head ("no-no", "yes-yes" shaking), soft skies, vocal folds, in the tongue. Trembling can be aggravated by overwork, stress, stimulants, and also with a rise in temperature. A noticeable decrease in the tremor is observed in the state of sleep or after drinking.

Often the disease is combined with dystonia or Parkinsonism. In this regard, there are questions of people with an essential tremor. Many patients associate the occurrence of a tremor with the presence of a family history of parkinsonism. However, as practice shows, these manifestations are characteristic of five percent of patients.

An essential tremor. Treatment.

All therapeutic methods are symptomatic and aimed at reducing the severity of tremors. In the initial stages, as a rule, medicines are not prescribed. In such cases, it is more appropriate to calm the patient by explaining to him that he does not suffer from Parkinsonism. In cases where the trembling affects the function of the hands and makes it difficult for any activity, medicines are prescribed. As first-line drugs, beta-blockers are used. For treatment, anticonvulsants (anticonvulsants) are also used. Their use is advisable in cases of ineffective exposure or poor tolerance of beta adrenoblockers. Benzodiazepines are prescribed to patients who experience increased tremor due to emotional distress. In cases of absence of effects from the administration of the above drugs, injections of neurotoxin of protein nature are possible. The most severe cases involve neurosurgical treatment.

Significant, but at the same time, a temporary decrease in tremor is observed when taking alcohol. However, over time, the patient needs to increase the dose, and refusal of alcohol leads to an increased intensity of jitters (higher than before drinking alcohol).