Causes of tremor of the head, hands, body? Tremor, tremor not only from Parkinson's

Causes of tremor of the head, hands, body? Tremor, tremor not only from Parkinson's
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A tremor is described as an involuntary and rhythmic movement that affects one or more parts of the body. It affects the upper limbs, hands, fingers, head, trunk or legs.

A tremor is described as a rhythmic movement that affects one or more parts of the body. It mainly affects the upper limbs, hands, fingers, then the head, jaw, chin, soft palate or vocal cords.

Less frequently, it affects the chest and trunk, and rarely the lower limbs and legs.

It affects any age group, including children, adolescents or adults. The most common period of onset is middle age and over 50 years of age.

It is a symptom that may not have an obvious and known cause. It is characterised by a familial occurrence. It is associated with fatigue, exhaustion or mental and psychological strain and overload.

Trembling and trembling of the hands is regularly associated with alcoholism. It is present during hangovers. It is also a symptom of withdrawal syndrome.

It can also hide other diseases, an example of which is the well-known Parkinson's disease.

The tremor can be observed externally and at a distance, or it can be detected simply by touch.

What is a tremor and why does it occur?
What is the most common cause?
And what other problems may be behind it?
Is there any prevention?
Read on to find out more...

How is tremor characterised and defined?

Tremor is defined as a regular, rhythmic, involuntary muscle movement. It affects any part of the body, but most commonly the upper limbs, hands and fingers.

In other cases, it affects the head, jaw and chin. It affects the muscles of the face, soft palate and vocal cords. In less common cases, it also affects the trunk, chest and rarely the lower limbs.

The tremor affects both limbs at once or only one. It is referred to as symmetrical or asymmetrical.

Symmetrical refers to a tremor that is present in approximately equal strength in both limbs.

Asymmetrical is a tremor of only one limb or a marked disproportion in the strength of the tremor between the limbs. An example is tremor or weakness in the right hand.

In addition, the main feature is rhythmicity, which may vary in frequency and amplitude.

In the context of tremor, we also encounter terms such as oscillation or hertz unit.

Oscillation = oscillation, a regular periodic occurrence
Frequency = frequency, number of periods, number of oscillations in a given time
Amplitude = deflection of an oscillating body from its equilibrium position, oscillation
Hertz - Hz = unit of frequency, frequency

Frequency is the main characteristic that is described. It has three degrees:

  1. low frequency = less than 4 Hz
  2. medium frequency = 4 to 7 Hz
  3. high frequency = above 7 Hz

Symptoms in tremor are:

  • rhythmic tremor of the hands, head, face, trunk, legs.
  • voice disturbance, too quiet speech
  • difficulty writing, drawing
  • impaired grip on eating utensils and drinking glasses or cups
  • these are everyday and normal activities
  • trembling and weakness of the limbs and muscles

The main causes of tremor are...

In many cases, it is not possible to determine what is behind it. It is often encountered in young people. In this case, it is a common, unhealthy condition that occurs and intensifies due to increased physical or mental stress.

One feels body tremors when exhausted and tired.
An example of this is the trembling of the body during an exam or a tremor (together with stomach tremors and nausea).
Such tremors are not a symptom of a disease.

This type, like the others, has a name. They indicate the cause of the onset. Although the exact source of the tremor may not have a known basis.

The table shows the division of tremor according to international/professional agreement

Type Description
Resting
  • or also static
  • Occurs at rest when the limb or body part is not loaded by gravity
  • the body part is not otherwise controlled by will
  • best observed and assessed in the supine position
Action
  • it is an involuntary movement that cannot be controlled by will
  • but occurs when the limb, arm, and muscles are activated, or when standing or moving
  • further subdivided into several subcategories:
Postural - In posture, when holding the body or part of the body against gravity, when holding a position against gravity.
Examples include extending the arms and upper limbs in front of oneself, which starts or exacerbates a tremor
Kinetic - When moving freely. Examples include bending the wrist of the hand up and down, as well as opening and closing the eyes.
It is further divided into:
  • Simple kinetic - in free movement, but which is not purposeful.
  • Intentional - in a purposeful movement, for example, when trying to lift a finger and touch the nose, the tremor is accentuated in front of the target
  • Kinetic, but related to a specific activity - it is accentuated or starts during specific activities, for example, writing, drawing or pointing with the hands
  • Isometric - triggered by muscle contraction, without the presence of movement, an example is holding a heavier book or weight in the hand and in the same position

Classification by: Consensus statement of the Movement Disorder Society on Tremor

How is tremor categorized?

In addition to the above division based on the presence of movement, tremor is further divided into several categories.

Physiological tremor

This tremor arises without a disease component being present. It is a common phenomenon that occurs mainly because of fatigue, exhaustion or exhaustion. It is triggered by excessive physical (muscle tremors during exercise) or mental activity. Examples include stress, test-taking and public speaking jitters.

One also shakes when angry and upset.
It is present throughout the day, when there is insufficient fluid intake or hunger.

It is also known professionally as neurotic tremor. Neurotic nature accompanies throughout life. It occurs in anxiety, depression and other psychological conditions.

It can affect the whole body, but usually it is the hands and fingers that shake.

Psychogenic tremor

Tremor can be a manifestation of various psychiatric disorders. It worsens when the mental load increases.

In addition, treatment of some psychiatric diagnoses requires medications that have the unwanted (unintended) and side effect of tremor.

Essential tremor

Also referred to as benign essential tremor, idiopathic or hereditary, familial tremor (idiopathic tremor). This is the most common type.

It is due to genetic predisposition, heredity and familial occurrence. However, it is not known exactly why it occurs.

It is reported that up to 50% of cases have a positive family history = family history.
Prevalence in the population is given as 0.4 to 4%.
On average, it occurs after the age of 50.

The person describes uncontrollable trembling of the upper limbs and hands - up to 97% of cases.

Tremor type: action, postural/kinetic and symmetrical tremor.

Possibly associated with tremors of the head and neck (48%), facial muscles, tongue and vocal cords (62%). More rarely, other parts of the body up to the lower limbs.

Tremor is associated and accentuated when moving the upper limbs, holding a cup, eating with cutlery or writing.
Stress and fatigue are also provocative factors.

Frequency between 4-10 Hz.

On the other hand...

The tremor subsides and relaxes at rest. An example is the cessation of the trouble when the hands are placed loosely on the mat.

Up to 50% of affected people report an abatement after alcohol intake.

The cause is unknown and in half of the cases there is another person in the family with essential tremor. It usually occurs in adulthood. However, this does not rule out onset at a younger age around 30 years.

As a rule, in people where a family history is confirmed, onset is earlier, even in childhood or adolescence.

On neurological and imaging examination, brain findings are normal, with no evidence of disease.

What helps with essential tremor?

There's no effective treatment that can eliminate it completely, because we don't know where it comes from.

Regimen measures are recommended, such as:

  • Avoiding stressful and debilitating situations
  • Wearing small weights on the wrist helps
  • possibly using weighted cups
  • limiting the intake of stimulants such as coffee

Certain beta-blockers or antiepileptic drugs are available. Injecting botulinum toxin, which disables and inhibits muscle activity in the area, may help temporarily.

Treatment may or may not help. It's highly individual.

In severe cases, surgery is an option to consider, with a choice between several methods. Examples include thalamotomy (brain surgery) or deep brain stimulation (with insertion of an electrode into the brain and a device similar to a pacemaker into the subcutaneous tissue of the torso).

Tremor is generally a factor that reduces overall quality of life. It limits a person's ability to do certain work or daily activities. It can be a problem when drinking or eating.

It also raises social issues.

The course and progression (advancement) is usually slow. The frequency or severity of the tremor worsens with increasing years.

In many cases it is confused with Parkinson's disease.

Parkinson's disease as a cause?

Parkinsonian tremor is the opposite of essential tremor. It is therefore a resting tremor. However, resting plus postural kinetic tremor is also described.

The more pronounced fading of tremor in Parkinson's disease occurs during movement. However, it may become more pronounced again over time during activity. There is typically a pause between the transition from resting to standing.

The frequency of the tremor is above 4 Hz.

Characteristic is involuntary tremor of the hands and fingers in the style of coin counting or pill rolling.

In Parkinson's disease, the onset is usually unilateral (asymmetrical). The overall picture of the disease is preceded by a sensation of trembling in the limb or inside the body.

The starting stimulus is mainly fatigue and exhaustion, but also excessive psychological stress and stress or tight concentration.

The tremor typically disappears during sleep.

Tremor in Parkinson's mainly affects:

  • upper limbs, hands, fingers
  • lips
  • chin and jaw
  • lower limbs

It does not affect the head, neck and vocal cords.

What is the fundamental difference between essential tremor and Parkinson's, in the table

Essential tremor Parkinson's disease
Familial occurrence Significant may or may not be
Usual frequency 5-10 Hz 4-6 Hz
What affects tremor Characteristic difference in symptoms and triggers
Calm relieves Exacerbates
Activity exacerbates mitigates
Mental concentration alleviates exacerbates
Writing Shaky handwriting Micrographia -
morbid writing in small print
Walking alleviates exacerbates
Attitude trembling while standing May be,
but a pause in the transition to standing is present
Kinetic tremor may or may not be accentuated over time
Limb tremor symmetrical asymmetric
Tremor of other parts of the body head, neck and vocal cords chin, jaw, lips
Effect of levodopa (drug) none Effect
Effect of alcohol alleviates None

What other causes may lie behind the trembling of the body, head, limbs

Essential tremor is not as well known as Parkinson's disease, although it is the most common cause. However, there are other reasons why it arises.

You ask: What causes tremors of the head, hands or body?

The table lists other causes of tremor

Neurological tremor In addition to Parkinson's, the following types are also listed:
  • dystonic tremor - dystonia is manifested by involuntary movements of muscles, especially neck, head, facial, facial muscles, eye muscles, and eye muscles (jaw spasms and displacement, grimacing, blinking)
  • polyneuropathic tremor - in nerve disease, associated with pain or tingling in the affected area, tingling or impaired sensation, often due to other diseases and as a complication of diabetes
  • vertebrogenic tremor - for problems and pain in the spine and for organic involvement and damage to the nerves at the level of the spine, examples include severe scoliosis or disc herniation
    • connects the cervical spine and hand tremor or head tremor
  • Cerebral and Holmes tremor - in cerebellar diseases, pronounced in the head and trunk with transfer to the extremities
  • but also:
For other diseases
Soup tremor
  • at normal dose or in unintentional or intentional overdose of drugs:
  • for respiratory diseases (bronchodilators - betamimetics)
  • cardiovascular diseases - beta-blockers, calcium channel blockers, adrenaline, amiodarone
  • corticosteroids - for allergy or inflammation
  • psychiatric drugs (tricyclic antidepressants, valproic acid, phenytoin)
Tremor in intoxication
  • Intoxication = poisoning of the body
  • medicines
  • drugs
  • chemicals
  • poisons
  • neurotoxic substances
  • also accidental or intentional
    • Alcohol and also during abstinence - even drug or nicotine withdrawal
    • steroids
    • lithium
    • lead
    • mercury
    • arsenic
    • food poisoning
    • BSE
    • and others

Read also:
Hand tremorscan be a harbinger of serious illness
What are the causes of tremors, internal body shaking even without temperature?

How to look for the cause and how to treat tremors

Treatment is chosen according to the category of tremor found and whether the trouble is so pronounced that it needs to be addressed. It is determined whether the tremor has a basis in a psychological condition or whether it is a physical or organic problem.

The initial diagnosis focuses on the medical history, i.e. information given by the person. This is followed by an examination of the tremor, whether it is visible externally or only on examination.

A basic examination of physiological functions is added, as tremor may also accompany high blood pressure, flu, fever, reaction to cold or other conditions. Laboratory blood tests are added.

Neurological examination is important. This is supplemented by imaging methods such as EEG, EMG, CT, MRI.

Let's not forget about prevention.

Prevention helps to avoid situations that cause difficulties and are not necessary for everyday life. It is mainly about excessive and unreasonable exertion, both mental and physical.

In addition, it is necessary to reduce the intake of stimulants such as coffee, energy drinks or medications that are related to tremor (after consulting a doctor and if possible). Plus supplement vitamins, minerals and relax.

Hand tremor demonstration

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