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Hand tremor, what is it and how to get rid of? - causes and treatment of tremor

In the practice of the therapist almost any specialization (pulmonologist, cardiologist, gastroenterologist) there are such patients who either complain of trembling in their hands, or it is detected during the examination. And then the doctor needs to understand: is this tremor a symptom of the disease with which the patient addressed, or is it a concomitant symptom and is not related to the underlying pathology.

Perhaps, neurologists are in a better position, as the tremor is studied in detail, or the tremor in the course of neurological diseases. Consider such a common symptom as trembling in the hands.


Hand tremor - what is it?

Hand tremor

Hand tremor is a state of hand tremors, which can be either short-term or permanent, symmetrical and one-sided, pronounced and erased, with a high amplitude and frequency of jitter and with a low, dependent on volitional effort and not obeying it.

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

There is nothing easier than to check your own body for the presence of tremor. To do this, stretch your arms forward, spread your fingers and hold them in that position for at least a minute. Most often, if the shiver is noticeable from the very first seconds, then it will gradually increase as fatigue increases in the hands.

Sometimes a shiver in the hands can be observed in a perfectly healthy person, but only in a short time, and only under the influence of strong emotional stimuli (agitation, strong fear).

There are many causes of tremor and treatment depends on them. It is obvious that alcoholic tremor or trembling hands of a child are completely different things.

Causes of hand tremor

Causes of hand tremor

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

Its causes are:

  • Increased emotionality. The tremor of hands at excitement can be in asthenic, neurotic personalities, artists;
  • Depression, post-traumatic stress disorder, traces of emotional stress;
  • Accentuations of character. Thus, in hysteroid psychopathy, a person may have, in separate periods of time, a tremor of the head and hands;
  • Drug reaction. Some remedies increase the convulsive readiness of the nervous system: some antidepressants, adaptogens (Rhodiola rosea, golden root, extracts of ginseng, lemongrass, eleutherococcus), lithium preparations, aminophylline, some antipsychotics;
  • Shivering in the hands can be caused by drinking strong coffee, tea, strong cigarettes;
  • The use of drugs such as amphetamines cause trembling in the hands;
  • A pronounced example of tremor in a healthy person can be chills during hypothermia, after heavy physical work (for example, working as a loader);

It is important that all these types of physiological tremors have an external factor, with the exclusion 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 talk, as a rule, or about poisoning (chronic), or about a nervous disease, or about other causes, for example, endocrine. Common causes of pathological trembling in the hands, which is a symptom of the disease, are:

  • Poisoning, for example, with lead, carbon monoxide, strychnine;
  • A separate line is chronic alcoholism and withdrawal syndrome;
  • Severe tremor in the hands is caused by hypoglycemia, which happens with type 1 diabetes (insulin-dependent);
  • Thyrotoxicosis and pathology of the adrenal glands also provoke prolonged tremor;
  • Chronic liver failure, with severe jaundice with fulminant forms of viral hepatitis. At the same time there is a “clapping” tremor - the hands tremble even if the person lies in bed;
  • The defeat of individual brain structures: stem, cerebellum, extrapyramidal nuclei causes persistent tremor, as in other extrapyramidal disorders. Hand shake with a lesion of the cerebellum is called intentional: the arms widen are intensified when trying to reach an object;
  • Family forms caused by hereditary predisposition;
  • Parkinson's disease;
  • Senile dementia, Alzheimer's disease;
  • Hepatocerebral dystrophy, or Wilson-Konovalov disease;
  • Multiple sclerosis and other demyelinating diseases (acute multiple encephalomyelitis);
  • Progressive forms of tick-borne encephalitis, chronic encephalitis and encephalomyelitis;
  • Anemias, including hereditary, conditions associated with chronic blood hypoxemia: helminthic invasions , habitual blood loss in hemorrhoids, ulcerative colitis and chronic stomach ulcers;

Separate nosological form is essential tremor, which can be family-like, but it does not contain any disorders of other systems. Hence the name - “essential”, which can be replaced by another: “tremor for unknown reasons”.

According to the description of some reasons, it becomes clear that the problem of tremor is very complex, and doctors cannot approach its explanation "sloppy."

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

As a result, it turns out that man has no Parkinson’s disease, but it turns out to be unnecessary for any doctor. Therefore, the problem of timely diagnosis of symptomatic tremor is acute for clinics.

Degrees of tremor

Degrees of tremor All manifestations of trembling in the hands must be classified according to severity, since sometimes this serves as a pretext for the transfer of the patient to a disability, due to persistent disability. Tremor is divided into:

1) Slightly pronounced, or appearing in certain periods of time that are much shorter than the normal state. Tremor does not affect the image and quality of life of the patient;

2) Moderate tremor. The patient is sometimes forced to change work, since he cannot control the fine and small movements. Some social functions suffer: for example, in a restaurant or a guest, a person can break a crystal glass, etc .;

3) Significant tremor. With him, the patient cannot serve himself: he can break his face and teeth with a glass of water, he is forbidden to use his fork, because you can poke out your eyes, such a person cannot hold a book, he is forced to fold it on the table, but at the same time turning the pages will be difficult.

Writing and typing text on a computer is also extremely difficult. Such persistent hand tremor occurs in multiple sclerosis with lesions of the cerebellum, as well as in hepatocerebral dystrophy and encephalitis.

Tremor in a child

Earlier, we considered the types of hand tremor in adult patients, and this suggested that they had a fully mature and functionally complete nervous system. In the event that a child's hand tremor is considered, it must be borne in mind that this symptom may be temporary.

It may simply arise due to the unreadiness and underdevelopment of the nervous system to receive and transmit impulses due to incomplete maturation of peripheral nerves.

As a rule, this type of violation occurs on the background of emotional overstrain and release of norepinephrine in the blood. This is usually a signal for active muscle contraction and increased muscle utilization of oxygen and glucose, but muscles respond with shaking.

It is important for the pediatrician to know that the baby overcame the critical periods of intrauterine development without “adventures”, and during pregnancy there were no diseases, intrauterine hypoxia of the fetus, and phenomena of placental insufficiency.

Other causes of tremor include intrapartum (perinatal) birth trauma, threatened miscarriage, prematurity, rapid delivery, congenital diabetes mellitus (diabetic fetopathy), or congenital syphilis .

Under normal conditions , with proper development of the child, most often after reaching the age of one year, the trembling hands of the kids pass. Otherwise, observation by a pediatric neurologist and subsequent treatment is required.

Alcohol Tremor

The tremor of the fingers of drunkards became popular proverbs and sayings, and became the subject of theatrical miniatures. In fact, the fault is the toxic effect of ethanol on the nervous system, as a result of which toxic polyneuropathy develops.

As a rule, shivering intensifies in the morning. In the initial periods of alcoholism, tremor is expressed impermanently, but over time it becomes permanent.

  • It can be treated only with the condition of complete abandonment of alcohol , otherwise all methods of detoxification will be ineffective.

Essential Hand Tremor

We have already said a few words about 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 shake occurs with a frequency of 8-10 times per second, sometimes the movements of the head, legs, voices are attached to the movements.

Essential tremor should not be confused with Parkinson's disease: in Parkinsonica, “posture hardening”, muscular rigidity, propulsion, “jagged” hypertonus are observed. In addition, with essential tremors, in contrast to Parkinson's disease, there is no progression, and patients for a long time retain memory, intelligence and the ability to self-service.

This disease is inherited in an autosomal dominant manner, from parents to descendants.

Tremor treatment, drugs

Tremor treatment, drugs Different types of these disorders require different types of therapy. You should know that the universal remedy for the tremor of the hands of humanity is still unknown.

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

Treatment of "normal" physiological tremor

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

It is very important to stop smoking completely, get an orthopedic pillow, and ventilate the room before going to bed. It is this group of diseases that is well treated with herbal soothing infusions, decoctions and traditional medicine.

Good effects for tremor have drugs:

  • tincture of motherwort, valerian;
  • "Phytosedan", prepare infusions, take 1/2 cup at night;
  • Novo Passit;
  • "Glycine". Dissolve 2 tablets at bedtime.

Sometimes, long-term antidepressants from the SSRI group are required to treat depression. With an improvement in mood, the manifestations of tremor are reduced. In some cases, courses of hypnotic drugs, such as zopiclone and zolpidem, are indicated.

Used drugs such as hexamidine (primidone). It belongs to anticonvulsant drugs, but has an effect on tremor.

Sometimes, tremor shows therapeutic fasting, as a result of which the physiological muscle tone changes, and the inhibition of muscle contraction returns to normal.

Essential tremor

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

  • Beta - adrenergic blockers (anaprilin, propranolol, obzidan, inderal). Starting dose - from 10 mg per day, with increasing doses to effective, under the control of blood pressure, pulse;
  • In severe tremor, antipsychotics and tranquilizers are indicated;
  • Carbonic anhydrase inhibitors (diacarb) are shown;
  • Large enough doses of vitamin B6 can slow down the progression of shivering, reduce its amplitude. The drug is used in the form of monthly courses, and the daily dose can be up to 8 ml;
  • Of the anticonvulsants, Levitracetam (an anticonvulsant drug) has proven itself well.

Parkinson's disease

For the treatment of extrapyramidal tremor of hands in Parkinson's disease, which is similar to the "coin counting", or "rolling pills", the "heavy artillery" is required, since it is necessary to influence the basal nuclei of the brain and the increased muscle tone. Examples of such drugs are:

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

These drugs, unlike the treatment of essential tremor, affect the exchange of neurotransmitters (mediators) in the deep structures of the brain and therefore self-treatment of other forms of tremor with these drugs is strictly prohibited.

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

In turn, a diagnostic medical search is impossible without the “strong points”, which are created by the doctor’s mindset on the basis of a detailed questioning of the patient, who will be greatly helped by this article.


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