Tremor of the hands - causes and treatment + drugs and recommendations

In the practice of a therapist of almost any specialization( pulmonologist, cardiologist, gastroenterologist) there are such patients who either complain of a shiver in their hands, or it shows up during the examination. And then the doctor needs to understand whether this tremor is a symptom of the disease that the patient has treated, or whether it is a concomitant symptom and not related to the underlying pathology.

Perhaps, in a more advantageous position, there are neurologists, since a detailed study of tremor, or trembling in the course of neurological diseases. Consider such a common symptom as a shiver in the hands.

Arm tremors - what is it?

Hand tremor is a state of hand trembling that can be either short-term or permanent, symmetrical and one-sided, pronounced and erased, with high amplitude and jitter frequency and with a low, volitional force that does not obey it.

As you can see, the trembling of the hands has many characteristics that the doctor needs to understand with the patient, since it is the methods of questioning and inspection that are of primary importance in diagnosing tremors of all kinds.

There's nothing easier than checking your body for shivering. To do this, you need to stretch your arms forward, spread out your fingers and hold them in that position for at least a minute. Most often, if the trembling is noticeable from the first seconds, it will gradually increase, as fatigue increases in the hands.

Sometimes shaking in the hands can be observed in a completely healthy person, but only in a short time, and only when exposed to strong emotional stimuli( excitement, intense fear).

There are many causes of tremors and treatment directly depends on them. Obviously, alcohol tremor or the trembling of the hands of a child - things are completely different.

Causes of hand tremor

Causes of tremor in the hands can be divided into two large groups. The first group includes physiological tremor, which is a functional disorder, can be temporary and does not indicate any diseases.

Its causes are:

• Increased emotionality. The tremor of the hands during excitement can be in asthenic, neurotic personalities, artists;
• Depression, post-traumatic stress disorder, traces of emotional stress;
• Character accentuation. Thus, in the case of hysteroid psychopathy, a person can have tremors of the head and hands in separate intervals of time;
• Drug reaction. Some remedies increase the convulsive readiness of the nervous system: some antidepressants, adaptogens( rhodiola rosea, golden root, extracts of ginseng, magnolia vine, eleutherococcus), lithium preparations, euphyllinum, some neuroleptics;
• Trembling in the hands can be caused by the use of strong coffee, tea, strong cigarettes;
• The use of drugs such as amphetamines causes a shiver in their hands;
• A striking example of a tremor in a healthy person can be a chill when undercooled, after heavy physical work( eg, work as a loader);

It is important that all these types of physiological tremor have an external factor, with the exception of which the condition should disappear. The doctor should be consulted if the tremor does not disappear 15 days after the normalization of the lifestyle.

Pathological tremor can speak, as a rule, of either poisoning( chronic), or a nervous illness, or other causes, for example, endocrine. Common causes of pathological tremor in the hands, which is a symptom of the disease, are:

• Poisoning, for example, lead, carbon monoxide, strychnine;
• A separate line is chronic alcoholism and withdrawal symptoms;
• Severe tremor in the hands is caused by hypoglycemia, which happens with type 1 diabetes mellitus( insulin-dependent);
• Thyrotoxicosis and the pathology of the adrenal glands also provoke prolonged tremor;
• Chronic liver failure, with severe jaundice in fulminant forms of viral hepatitis. In this case, there is a "clapping" tremor - hands tremble even if a person lies in bed;
• The defeat of individual brain structures: the trunk, cerebellum, extrapyramidal nuclei causes persistent tremor, as in other extrapyramidal disorders. The trembling of the hands with the defeat of the cerebellum is called intentional: the swings of the arms become stronger when trying to reach up to an object;
• Family forms caused by hereditary predisposition;
• Parkinson's disease;
• Senile dementia, Alzheimer's disease;
• Hepatocerebral dystrophy, or Wilson-Konovalov's disease;
• Multiple sclerosis and other demyelinating diseases( acute disseminated encephalomyelitis);
• The progeny forms of tick-borne encephalitis, encephalitis and encephalomyelitis of chronic course;
• Anemia, including hereditary, conditions associated with chronic blood hypoxemia: helminthic invasion, habitual hemorrhage in hemorrhoids, ulcerative colitis and chronic gastric ulcer;

A separate nosological form is an essential tremor that can be of a family nature, but there are no disorders of other systems. Hence the name - "essential", which can be replaced by another: "trembling for unknown reasons."

According to some reasons it becomes clear that the tremor problem is very complicated, and doctors can not be approached to explain it, "through the sleeves".

There is an unhealthy practice, without understanding, immediately put the patient, especially after 60 years, diagnosed with "Parkinson's disease", and send such a person to the center of extrapyramidal pathology.

As a result, it turns out that there is no Parkinson's disease in humans, but it turns out to be unnecessary to any of the doctors. Therefore, the problem of timely diagnosis of symptomatic tremor is acute before the doctors of polyclinics.

Degrees of tremor

All manifestations of tremor in the hands must be classified according to the severity level, as this sometimes serves as an excuse for transferring the patient to a disability, due to persistent disability. The tremor is divided into:

1) Slightly expressed, or appearing at certain time intervals, which are significantly shorter than the usual state. Tremor does not affect the image and quality of life of the patient;

2) Moderate tremor. The patient is sometimes forced to change jobs, because he can not control subtle and small movements. Suffer some social functions: for example, in a restaurant or a guest a person can break a crystal glass, etc.;

3) Significantly marked tremor. With him, the patient can not service himself: he can break his face and teeth with a glass of water, he is forbidden to use a fork because he can stab his eye, a man can not keep a book, he has to fold it on a table, but at the same time leafing through pageswill be difficult.

It's also extremely difficult to write and type text on a computer. Such persistent trembling of hands occurs with multiple sclerosis with cerebellar involvement, as well as in hepatocerebral dystrophy, encephalitis.

Tremor in a child

Earlier we considered the types of arm tremors in adult patients and this assumed that they had a fully ripened and functionally complete nervous system. In the event that the hand tremor in the child is considered, one should keep in mind that this symptom may be temporary.

It can simply arise because of the unpreparedness and underdevelopment of the nervous system to receive and transmit impulses due to incomplete ripening of the peripheral nerves.

Typically, this type of disorder occurs against the background of emotional overstrain and the release of norepinephrine into the blood. Usually this is a signal to active muscle contraction and increased utilization of oxygen and glucose by the muscles, but the muscles react with trembling.

It is important for the pediatrician to know that the critical periods of intrauterine development were overcome by the baby without "adventures", and during pregnancy there were no diseases, intrauterine hypoxia of the fetus, phenomena of fetoplacental insufficiency.

Other causes of tremor include intranatal( perinatal) birth trauma, the threat of abortion, prematurity, swift birth, congenital diabetes( diabetic fetopathy), or congenital syphilis.

Under normal conditions, , with the proper development of the child, most often after reaching the age of one year, the trembling of the hands in toddlers passes. Otherwise, it is necessary to observe the child's neurologist and the subsequent treatment.

Alcoholic tremor

Tremor of fingers of the hands of drunkards entered into folk proverbs and sayings, and became the subject of theatrical miniatures. In fact, the whole fault is the toxic effect of ethanol on the nervous system, which results in toxic polyneuropathy.

As a rule, the tremor increases in the morning. In the initial periods of alcoholism, the tremor is not constant, but over time it becomes permanent.

• To treat it it is possible, only with a condition of a full refusal of alcohol, differently all methods of detoxification will appear ineffective.

Essential tremor of the hands

Above, a few words have already been said about the essential tremor. To supplement the picture a little, it should be said that this disease is common in 2% of the young population, under the age of 40, and much more often in old age.

Hand tremors occur at a frequency of 8-10 times per second, sometimes movements are joined by a tremor of the head, legs, and voice.

To confuse an essential tremor with Parkinson's disease it does not follow: parkinsonics has a "frozen posture", muscle rigidity, propulsion, "jagged" hypertonia. In addition, with essential jitter, unlike Parkinson's disease, there is no progression, and patients for a long time retain memory, intelligence and self-service ability.

This disease is inherited by an autosomal dominant type, from parents to descendants.

Hand tremor treatment,

medications Different types of these disorders require different types of therapy. It is necessary to know that universal medicine for hand tremor is not yet known to mankind.

Therefore, consider how to cope with the physiological tremor that occurs in the vast majority of patients in patients with an essential tremor, and show by what means extrapyramidal tremor is treated in Parkinson's disease.

Treatment of the "ordinary" physiological tremor

To get rid of tremor of the hands caused by a physiological cause is easiest. Non-drug therapies are associated with the normalization of the work and rest regime, full sleep, the refusal of heavy physical work and the exclusion of all factors that cause trembling( refusal of coffee, tea, alcohol).

It is very important to completely quit smoking, purchase an orthopedic pillow, and ventilate the rooms before bed. It is this group of diseases that is well treated with herbal soothing infusions, broths and folk medicine.

Good effects with tremor are medications:

• tincture of motherwort, valerian;
• "phytosedan", prepare infusions, take 1/2 cup at night;
• "Novo-Passit";
• "Glycine".To dissolve 2 tablets before a dream.

Sometimes it takes a long time to take antidepressants from the SSRI group to treat depression. With an improvement in mood, the manifestations of tremor decrease. In some cases, courses of hypnotics such as zopiclone and zolpidem are indicated.

Use drugs such as hexamidine( primidone).It refers to anticonvulsant drugs, but it has an effect with tremor.

Sometimes, tremor shows therapeutic starvation, which changes the physiological muscle tone, and the braking regulation of muscle contraction comes back to normal.

Essential tremor

Treatment of an essential tremor is carried out according to other principles. As a rule, the following drugs have a pronounced effect:

• Beta - adrenoblockers( anaprilin, propranolol, obzidan, inderal).Starting dose - from 10 mg per day, with increasing dose to an effective, under the control of blood pressure, pulse;
• With severe tremor, neuroleptics and tranquilizers are shown;
• The inhibitors of carbonic anhydrase( diacarb) are shown;
• Quite large doses of vitamin B6 can slow the progression of jitter, reduce its amplitude. The drug is applied in the form of monthly courses, and the daily dose can be up to 8 ml;
• Of anticonvulsants, levitracetam( an anticonvulsant drug) has proved to be well established.

Parkinson's disease

For the treatment of extrapyramidal hand tremors in Parkinson's disease, which is similar to "counting coins" or "rolling pills", it requires "heavy artillery", since it is necessary to influence the basal nuclei of the brain and the increased muscle tone. An example of such drugs are:

• Levodopa;
• Bromocriptine;
• Amantadine;
• Memantine.

These drugs, in contrast to the treatment of essential tremor, affect the exchange of neurotransmitters( mediators) in the deep structures of the brain and therefore independent treatment of these forms of other forms of tremors is strictly prohibited.

The tremor of the hands, the causes and treatment of which we have considered, should not be an annoying reason, which is "overlooked".On the contrary, this symptom may be one of the early markers of metabolic processes, and careful diagnosis will help in a timely manner to cope with serious diseases.

In turn, a diagnostic medical search is impossible without "strong points", which are created by the doctor's thinking on the basis of a detailed questioning of the patient, to which this article will largely help.