Essential tremor: causes and symptoms

Essential tremor is a trembling of the head, jaw, arms, legs, tongue, noticeable to others, which is a characteristic symptom of a pathology of the nervous system. Other terms are also used in medicine - Minor's syndrome, familial, benign or congenital tremor, idiopathic tremor (hereditary).

The main problem that owners of the disease face during its development is difficulty in professional and social activities; severe cases are associated with the loss of the ability to self-care. The diagnosis is confirmed in males and females. In most cases, the disease complicates the lives of older people; it appears after the 45th birthday, but can develop even in a child.

Causes of pathology

Essential tremor is not associated with external causes. In most cases, the appearance of signs characteristic of pathology is provoked by changes in human genes, their mutation. The probability of transmitting the altered gene from one of the parents is high and is observed in 50% of cases. If characteristic chromosome changes are present in a man and woman who conceive a child, the probability of developing Minor disease is 75%. One of the names of the pathology - familial tremor - directly points to an important fact: if there is a confirmed diagnosis in the parents, there is a high probability that the disease will develop in children during the course of their lives.

Essential tremor can occur for reasons not related to heredity. Its development is provoked by certain factors:

• loss of the ability to interact between several areas of the brain (cerebellum, brainstem, red nuclei);
• necrotic processes in the brain, death of its cells;
• damage to areas of the brain tissue of the head due to trauma, the presence of hemorrhages;
• changes in hormonal balance due to thyroid dysfunction;
• renal and liver failure;
• consequences of taking medications, exposure to chemicals;
• tumor processes in the brain.

Treatment

It can be either medicinal (pyridoxine, primidone, etc.) or surgical. The latter is resorted to when conservative methods are ineffective and the patient’s condition worsens. But we should not forget about therapy with folk remedies, although official medicine treats them quite warily.

Pharmacological methods

• beta-adrenergic receptor blockers reduce tremors of the hands and head, making it possible to significantly delay complete disability;
• the newest vasoconstrictor drugs related to sodium channel blockers, benzodiazepines and mediators of inhibition processes in the central nervous system (the latter are based on gamma-aminobutyric acid, GABA) have a similar effect;
• pyridoxine (vitamin B6) makes the symptoms less obvious, but treatment with such drugs is considered insufficiently effective today;
• primidone will reduce the severity of clinical manifestations.

Surgery

• destruction of the ventrointermediate nuclei of the thalamus provides a significant reduction in tremor (the consequences of the operation are irreversible);
• hardware stimulation of deep areas of the brain; carried out through the introduction of electrodes controlled by an implanted device.

Phytotherapy

Treatment with folk remedies will not be able to completely cope with the disease, but it will ease its course and simplify the basic therapy:

Chew 2-3 peas of tansy flowers for 5-10 minutes. The saliva should be swallowed and the cake should be spat out. Duration of treatment: as desired.

Complex healing infusion. Mix mint leaves, chamomile flowers and dried grass (1 part each); hawthorn fruits, rhizomes with valerian roots (2 parts); motherwort grass (3 parts). 2 tbsp. l. collection, pour 400-450 ml of boiling water and keep on low heat for 5-7 minutes. Pour into a thermos and let it brew for 90 minutes. Dosage regimen: 3 times a day, 100-110 ml for 30 minutes. before meals. Duration of treatment: for a month, then repeat after a 10-day break. Motherwort tea. 2 tsp

Pour the dried (important!) greens of the plant into a glass of boiling water, cover with a lid and leave for 10-15 minutes. brew

Dosage regimen: the resulting volume of liquid should be drunk in equal portions per day. Duration of treatment: as desired.

Physiotherapy

• a specially developed exercise therapy complex (reduces tremors of both hands and head);
• dancing or aerobics classes;
• gymnastics, preferably outdoors;
• exercises to maintain fine motor skills;
• leisurely daily walks in the fresh air.

Varieties and symptoms

You can understand that Minor's disease is developing by several pronounced signs, which are often observed in combination:

• regardless of the current state of the muscles (their tension, rest or relaxation), a small trembling occurs in parts of the body, noticeable to people around them;
• muscle tone increases and remains constant;
• in a state of stress, under severe emotional or physical stress, and even with slight excitement, after drinking alcoholic beverages, tremor becomes especially noticeable, trembling of body parts occurs with an increase in amplitude without changing their muscle tone;
• the person’s tongue begins to tremble, the symptom is revealed during a medical examination, but remains invisible to the patient;
• the rhythm of breathing is disrupted;
• a special timbre of the voice appears, in an ordinary conversation speech acquires a new quality - as if the words are spoken by a person in a state of strong excitement, the spoken sounds vibrate, speech becomes slurred;
• involuntary or slight twitching of the corners of the eyes, lips, movement of the jaw, cheeks is observed - others think that the person is grimacing;
• Akathisia occurs - a condition characterized by a constant desire to change position and move actively.

The listed symptoms are not accompanied by a deterioration in mental activity; the person retains his characteristic “clarity of mind.” If essential tremor develops over a long period of time, over several years, the patient's lower limbs may tremble. Such manifestations lead to changes in gait. It becomes shuffling and unstable, and the person begins to move carefully, in small steps.

Minor's disease has several varieties. Its classification assumes the presence or absence of similar symptoms in close relatives of the patient. Based on this feature, two types of pathology are distinguished:

• familial, genetically determined essential tremor, it is inherited from one, and sometimes from both parents;
• sporadic form of the disease - occurs for the first time in the family, the cause of the process is a gene mutation.

Depending on the age of the person when the manifestations of the pathology became noticeable, a special, clarifying form is established corresponding to the periods of life:

• senile (in people over 60 years of age);
• presenile (age group 45–60 years);
• mature;
• youthful;
• children's room

Minor's disease can vary in severity of manifestations - from minor and moderate to pronounced and severe. Its course is accompanied by twitching of a certain part of the body, so a diagnosis of essential tremor of the head or hands can be made.

Treatment

There are several ways to combat essential tremor. Doctors offer traditional treatment methods and folk remedies that improve the general condition of a patient with this diagnosis. Physiotherapeutic techniques are also actively used. In complicated cases, patients are advised to agree to surgery.

Treatment of pathology of the nervous system requires a comprehensive approach. In this case, the patient can count on a successful result of the therapeutic course. Many patients are recommended to additionally attend consultations with a psychiatrist or psychologist. Conversations with specialists will help you get rid of unnecessary emotional stress.

Medication

Anaprilin is taken orally 10-30 minutes before meals, washed down with plenty of liquid, the dosage regimen is individual and selected by the attending physician.

Your doctor will first recommend drug therapy. The most effective way to treat essential tremor is with medications. Most often they are presented in a dosage form such as tablets.

Medications can help reduce the intensity of tremor symptoms:

• Anticonvulsants (Primidone, Levetiracetam).
• Beta-adrenergic receptor blockers (Metoprolol, Anaprilin).
• B vitamins (preparations with vitamin B6 are especially useful).
• Tranquilizers (Oxazepam, Diazepam).

Your doctor may recommend injecting Botox into areas that are suffering from twitching. Typically, the drug is injected into the elbows and facial muscles responsible for facial expressions.

Surgical

In rare cases, doctors insist on surgical intervention. Patients usually manage to limit themselves to drug therapy. If the symptoms are too severe and interfere with a person’s normal life, then the decision is made in favor of a radical treatment method.

Doctors may prescribe destruction of the ventrointermediate nuclei of the thalamus for a patient with essential tremor. It is in these structures that interaction between different parts of the brain occurs. After this, a decrease in the severity of clinical manifestations of the disease is observed.

Patients may be asked to insert electrodes directly into the brain. They are connected to a special device that a person can always carry with them. Thanks to it, an effect is exerted on the organ, due to which the amplitude and frequency of trembling are significantly reduced.

Physiotherapy

Physical therapy has a positive effect on the condition of a person diagnosed with essential type tremor. A specialist should select a set of exercises for the patient. At first, he will observe that the training is performed correctly. If no problems are noted during the classes, then the person will be able to do exercise therapy independently at home.

Physical therapy for essential tremor is aimed at increasing control over the muscles of your own body. The complex necessarily includes exercises for the development of fine motor skills of the fingers.

Daily therapeutic exercises allow a person to cope with intense manifestations of trembling in different parts of the body.

In addition to exercise therapy, contrast showers, acupuncture, massages, hirudotherapy and balneotherapy are recommended for patients with essential tremor.

Folk remedies

Patients with essential tremor should include a collection of chamomile flowers in their therapy.

As an auxiliary treatment, remedies proposed by traditional medicine can be used. Most of them are based on natural raw materials, which have a beneficial effect on the activity of the nervous and other systems of the human body.

You can start treatment with folk remedies only after consulting your doctor on this matter. He will help you choose the safest and most effective recipes that can be used in conjunction with medications.

Patients with essential tremor should include the following non-traditional remedies in their therapy:

1. A mixture of dry motherwort, valerian roots and hawthorn fruits. An infusion is prepared from them, which should be drunk three times a day, 2-3 tsp.
2. A collection of chamomile flowers and mint leaves. It is recommended to take this decoction three times a day, 1 glass.
3. A decoction of dried motherwort. After infusion, the finished product is taken at 150 mg throughout the day.
4. A mixture of sunflower oil and coffin leaves. The resulting ointment must be rubbed onto problem areas that are shaking due to illness.

You can also periodically chew tansy peas for 2-3 minutes. Saliva must be swallowed. But the fruits need to be spit out.

Diagnostics used

Familial tremor has similar symptoms to other pathologies. These are multiple sclerosis, Parkinson's disease, neurotic muscle contractions. Similar symptoms can be provoked by alcohol addiction, exposure to toxins on the body, and malnutrition of the brain due to vascular dystonia.

An important part of the diagnosis is taking an anamnesis. The doctor conducts a detailed interview with the patient. He is interested in whether blood relatives have been diagnosed with Minor disease or its symptoms. The specialist pays special attention to the severity of the main signs of pathology, he evaluates:

• when and in what parts of the body do characteristic twitching occur;
• presence of increased muscle tone.

To confirm the disease essential tremor, diagnostics are prescribed - instrumental and laboratory. Methods used:

• MRI or computed tomography (the choice of examination depends on the availability of equipment in the clinic and the financial capabilities of the patient);
• encephalography is necessary to assess brain activity (electrical);
• angiography of the vascular system supplying the brain;
• radiography.

For research in the laboratory, you need to donate blood (general and biochemical tests). A sample will be taken from the patient for genetic testing to identify “problem” genes. To exclude the development of diseases with similar symptoms for the patient, diagnosis is required using differential methods.

If essential tremor is confirmed, special treatment is prescribed.

Effective therapy

The severity of symptoms, the nature of their manifestations, and the age of the patient determine the features of treatment. The main purpose of therapy is to reduce the severity of symptoms of neurological abnormalities, which means the patient’s possible return to his usual life. The complexity of procedures is the main guarantee of the success of further prognosis. The manifestations can be controlled by prescribed medication and numerous physical procedures; in difficult cases, surgery may be prescribed. Additional treatment methods – homeopathy, the use of traditional medicine recipes – can improve the patient’s condition.

Physiotherapy

Essential hand tremor is a neurological pathology. Physiotherapy methods are applicable for its treatment. The doctor prescribes traditional procedures:

• massage (relaxing);
• acupuncture;
• medicinal baths;
• cold and hot shower.

The patient will receive a referral for therapeutic exercises. Its main goal is to teach the patient to control the activity of his own muscles, to resume proper breathing when the diaphragm is involved in the pathological process.

Severe hand tremors can be corrected by using special exercises to stimulate fine motor skills of the hands. This is a special complex or the use of ordinary small objects for manipulation. During the period of long-term treatment, persistence, patience, and mutual understanding are required from the patient and those around him.

Drug therapy

The patient is prescribed several groups of drugs. To reduce the amplitude of tremor and its severity, drugs from the group of beta blockers (Anaprilin, Primidon) are used. Carbonic anhydrase inhibitors (Diacarb, Neptazan) enhance the ability to transmit nerve impulses in the brain. The drugs Primidon and Clonazepam have relaxing and anticonvulsant properties. Anxiety conditions (in chronic manifestations) are treated with tranquilizer tablets, and the patient is prescribed Diazepam. Therapy can be supplemented with Bromocriptine, a drug classified as an antiparkinsonian drug. The patient is prescribed B vitamins, especially intramuscular administration of Pyridoxine. Correction of tremor manifestations is carried out using Botox injections; a long course of using a drug based on it is required (at least 6 months).

Drug treatment is carried out under medical supervision due to the risk of side effects. If they are available, the composition of the medicines is adjusted.

Surgery

The surgical treatment method is applicable in cases where it is impossible for the patient to prescribe medication for therapy due to the characteristics of his condition, as well as in cases where the treatment has not brought noticeable results.

There are two types of surgeries used to treat essential tremor:

• installation of electrodes to stimulate brain neurons and restore connections between its parts;
• removal of a section of brain tissue that causes tremor.

Traditional methods of treatment

Traditional medicine recipes help reduce the manifestations of Minor's disease. A doctor may recommend the use of herbal medicine - taking infusions, teas and decoctions from available natural raw materials.

Components in the recipe can be “soothing” herbs - mint, lemon balm, motherwort, valerian. A noticeable effect is observed when taking products based on hawthorn fruit, peony root, and chamomile.

Taking any medicine on your own is dangerous. Its ingredients, method of preparation, and treatment regimen are prescribed only by a doctor.

Treatment of essential tremor

Patients with pathological tremors that are not pronounced do not require drug treatment. Enough:

• avoid consumption of strong coffee and tea;
• stop smoking and alcoholic beverages;
• avoid nervous tension and stress.

With more intense symptoms of essential tremor, medication or surgery is prescribed. Surgeon intervention is used in the absence of results from conservative therapy.

Physiotherapeutic

Physiotherapy procedures help well in the initial stage of the disease:

• performing exercise therapy exercises that reduce tremor of the hands and head;
• performing exercises that support fine motor skills;
• light aerobics and dancing classes;
• frequent active walks in park areas;
• relaxing massage treatments;
• acupuncture.

Medication

In the traditional treatment of essential tremors, several groups of drugs are indicated:

• beta-blockers - Anaprilina, Metoprolol, Propranolol, Obsidan. The drug “Propranolol” has the greatest effect (has contraindications);
• anticonvulsants – Phenobarbital, Lamotrigine, Clonazepam, Carbamazeline;
• tranquilizers – Sibazon, Relanium, Diazepam;

Injections are also used:

1. Vitamin B6, 2 monthly courses per year
2. Botox, which blocks muscle contractions (positive effect within 10 days).

Of all medications, beta-blockers have the greatest therapeutic effect. If they are personally immune, drugs from other groups are taken.

Surgical

When drug treatment is absolutely ineffective and health is constantly deteriorating, surgical intervention is used. A person suffering from hereditary tremors undergoes brain surgery. Stereotactic destruction of the ventrolateral nuclei of the thalamus helps to achieve a good effect in reducing the symptom of tremor. However, the consequences of the operation are irreversible.

Hardware brain stimulation is also used with the introduction of electrodes into the deep parts, which generate electrical impulses that suppress trembling.

Folk

Treatment with folk remedies will not rid a person of pathology, but will alleviate the course and symptoms of the disease.

The most famous remedy is tansy flowers. Dry peas of flowers are chewed, the saliva released is swallowed, and the resulting cake is spat out. Also shown:

• soothing herbs - valerian, peony, motherwort. They are sold in pharmacies as tinctures or herbal teas;
• medicinal herbs with mild antispasmodic effects - hawthorn, lemon balm, mint;
• infusions of periwinkle herb, juniper roots - to improve blood flow;
• medicinal baths with aromatic oils of chamomile and chrysanthemum flowers - a good calming effect that reduces the symptoms of the disease.

Eastern medicine recommends mudra against essential tremor. These are statistical exercises that are performed alternately throughout the day. To treat “shaking” use:

• “wind” mudra: the base of the thumb is connected to the index finger, the rest remain straight and relaxed;
• “life” mudra: connect the fingers together - the thumb, ring and little fingers (their pads), the other two should remain straight.

Prognosis and prevention

Essential tremor is not a fatal disease, but it can make life significantly more difficult. The patient not only experiences a deterioration in health, but his new condition provokes social changes. They are associated with the impossibility of habitual communication with people, limitation of the ability to self-care and engage in usual professional activities. In difficult cases, the patient is assigned a disability, and if the pathology progresses in a young man of military age, he is exempted from military service.

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