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Tremors
Published in Charles Theisler, Adjuvant Medical Care, 2023
The disorder generally affects men and women equally and is more common in people aged 40 and older. Essential tremors include postural or intention (action) types. There are many different causes of tremors including neurological disorders, certain drugs (e.g., corticosteroids, or amphetamines or antipsychotics), alcohol withdrawal, mercury poisoning, hyperthyroidism, and liver failure.2 Reducing the tremor is the goal of treatment.
Hyperkinetic Movement Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Morales-Briceno Hugo, Victor S.C. Fung, Annu Aggarwal, Philip Thompson
A rhythmic, sinusoidal (oscillatory), periodic (repetitive) movement. Apart from essential and dystonic tremor, virtually all causes of tremor are symptomatic of an underlying neurological or systemic disorder (including drug side effects).
Intention Tremor
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Common types of tremor are: Tremor at rest.Postural tremor.Flapping tremor.Senile tremor. Essential familial tremor.Hysterical tremor.
Contemporary challenges in the diagnosis and management of chronic inflammatory demyelinating polyneuropathy
Published in Expert Review of Neurotherapeutics, 2022
Pain, cramps, and unpleasant sensory symptoms, although unusual in early stages and often suggestive of other diagnoses, may become prominent and require targeted therapy [98]. Fatigue is very common and likely to result from multiple factors, including neuropsychological, with no demonstrated relation to the degree of peripheral nerve damage, and no evidence-based drugs [99]. Hence, fatigue-management programmes with multidisciplinary involvement are ideal in such cases, although frequently unavailable. Tremor is uncommonly severe but may be disabling in some patients in whom it may be considered the predominant symptom [100]. Treatments used which mirror those for essential tremor, are of variable effect, but perseverance is appropriate in highly symptomatic individuals. Restless legs syndrome may be common and occasionally disturbingly symptomatic but respond well to available therapies [101]. Neuropsychiatric manifestations, including anxiety and depression may occur linked to understandable difficulties coming to terms with a long-term disabling disease, but with also, in turn, direct consequences on physical function, treatment response and its amplitude, as well as the applicability of patient reported outcome measures [102]. Targeted treatment is highly desirable and may be very helpful in contributing to global improvement.
Brain microstructural changes and cognitive function in non-demented essential tremor patients: a diffusion tensor imaging study
Published in International Journal of Neuroscience, 2021
Y. Sengul, H. O. Temur, Z. Corakcı, H. S. Sengul, H. Dowd, I. Ustun, A. Alkan, E. D. Louis
We recruited 81 consecutive patients with tremor between 18 and 76 years old who visited the general or movement disorders clinic of the Neurology Department of the Bezmialem Foundation University Hospital, Eyup Sultan, and Fatih Additional Buildings in Istanbul, Turkey, during the six-month period between January 2018 and July 2018. The study was conducted according to the ethical principles stated in the Declaration of Helsinki and was approved by the Ethical Committee of the Bezmialem Foundation University Hospital. Written informed consent was obtained from the participants after the nature of the procedures had been fully explained. Sociodemographic characteristics, family history (first- and second-degree), and duration of disease were recorded. We ruled out other possible causes of tremor using the following blood tests: thyroid hormone, vitamin B12, folate, other biochemical blood tests (e.g. liver and kidney functions), and hemogram. An ophthalmologist examined patients for Kayser-Fleischer rings in those younger than 45 years.
Raymond D. Adams and Joseph M. Foley: Elaborating the neurologic manifestations of hepatic encephalopathy (1949–1953)
Published in Journal of the History of the Neurosciences, 2021
A decade after my discussion with Foley on rounds, Günther Deuschl and colleagues presented an article titled, “Consensus Statement of the Movement Disorder Society on Tremor” (Deuschl, Bain, and Brin 1998). The document defined tremor as a “rhythmical, involuntary oscillatory movement of a body part” (Deuschl et al. 1998); as such, arrhythmic or quasi-rhythmic movements like asterixis are not tremors. Consequently, these authors clearly distinguished asterixis from tremor and classified it as a form of “negative myoclonus,” adopting the formulation of neurologist Robert R. Young and physiatrist Bhagwan T. Shahani (1986): (a) “Conditions such as asterixis … can be misinterpreted as tremor” (Deuschl et al. 1998, 2); (b) “It must be emphasized that so-called jerky tremors are often not tremors but, rather, myoclonus or asterixis” (Deuschl et al. 1998, 15); and (c) “Asterixis is a negative myoclonus with sudden lapses of innervation. When the EMG pauses are long (> 200 ms), typical flapping tremor [sic] during tonic contraction results. When the pauses are shorter, the clinical phenomenology resembles a somewhat-irregular, high-frequency tremor” (Deuschl et al. 1998, 16). Deuschl and colleagues categorized asterixis as a nontremor (“negative myoclonus”) that was part of the differential diagnosis of true tremors.