| |
Complete
guide on alternatives treatment of all disease please read our
e-book
Classification of Tremor
and Update on Treatment
P. DAVID CHARLES,
M.D., GREGORY J. ESPER,
B.S., THOMAS L. DAVIS,
M.D., ROBERT J. MACIUNAS,
M.D., and DAVID
ROBERTSON, M.D.
Vanderbilt
University School of
Medicine
Nashville, Tennessee
Tremor is a symptom of
many disorders,
including Anxiety,
Celiac disease,
hyperthyroidism,
Multiple sclerosis,
Parkinson's
disease, essential
tremor, orthostatic
tremor, cerebellar
disease,
neuropathy and alcohol
withdrawal. Tremors may
be classified as, resting or action
tremors. Treatment
should be aimed at the
primary cause of the
tremor as Celiac disease
can trigger cerbellar
degeneration and maybe
even parkinson so a
gluten free diet should
be tried in all patients.
Parkinson disease tremor therapy
is with sinemet.
Essential tremor is
treated with propranolol
or primidone.
Propranolol may be
useful in treating
alcohol withdrawal
tremor, gluten free diet
may control the cerebellar tremor
associated with multiple
sclerosis. Clonazepam
may relieve orthostatic
tremor. Other agents are
also available for the
treatment of tremor.
When medical therapy
fails to control the
tremor, surgical options
such as thalamotomy,
pallidotomy and thalamic
stimulation should be
considered in severe
cases. Thalamic
stimulation, the most
recent of these surgical
approaches, offers the
advantage over ablative
procedures of
alleviating tremor
without the creation of
a permanent lesion.
Tremor is the
uncontrollable, rhythmic
movement of any part of the
body, to find a treatment
one has to narrow down the
cause of the disease.
Rhythmicity distinguishes
tremor from disorders in
which tremor may be a
component, such as
choreoathetosis and
dystonia, and its biphasic
nature distinguishes tremor
from clonus.1
The frequency and amplitude
of a tremor vary to the
degree that the tremor may
be hardly noticeable or
severely disabling.
Frequency can be divided
into three categories of
oscillations per second:
slow (3 to 5 Hz),
intermediate (5 to 8 Hz) or
rapid (9 to 12 Hz).3
Amplitude may be classified
as fine, medium or coarse,
depending on the
displacement produced by the
tremor about the fixed
plane.3
A coarse tremor has a large
displacement, whereas a fine
tremor is barely noticeable.
Tremor may be unifocal,
multifocal or generalized,
and may affect the head,
face, jaw, voice, tongue,
trunk or extremities.
 |
TABLE 1
Classification
of Tremors,
and Their
Characteristics
and
Treatment
|
Type of
tremor
|
Frequency
|
Occurrence
|
Etiology
|
Treatment*
|
|
Postural
tremor |
5 to 9 Hz |
When limb is
positioned
against
gravity
|
Physiologic
tremor,
essential
tremor,
alcohol or
drug
withdrawal,
metabolic
disturbances,
drug-induced
tremor,
psychogenic
tremor |
Beta
blockers,
primidone
(Mysoline),
acetazolamide
(Diamox),
clonazepam
(Klonopin),
botulinum
toxin, brain
gabapentin
(Neurontin),
deep
stimulation,
thalamotomy |
|
Rest tremor |
3 to 6 Hz |
When limb is
fully
supported
against
gravity and
the muscles
are not
voluntarily
activated |
Parkinson's
disease,
multiple-
systems
atrophy,
progressive
supranuclear
palsy,
drug-induced
tremor,
rubral
tremor,
psychogenic
tremor |
Levodopacarbidopa
(Sinemet),
anticholinergics
and other
antiparkinsonian
agents, deep
brain
stimulation,
pallidotomy,
thalamotomy |
|
Action
tremor† |
3 to 10 Hz |
During any
type of
movement |
Cerebellar
lesions,
rubral
tremor,
psychogenic
tremor |
Wrist
weights,
isoniazid |
*--Drugs and
other
treatments
are
generally
listed in
the order in
which they
should be
tried. An
adequate
trial of
each
medication
must be
tried before
the agent is
judged to be
ineffective.
Many of
these drugs
are not
specifically
labeled for
the
treatment of
tremor or
have not
undergone
extensive
studies to
support
their use in
the
treatment of
tremor.
†--Action
tremor
includes
intention
tremor
(exacerbation
toward the
end of
goal-directed
movement),
kinetic
tremor
(during any
type of
movement)
and
task-specific
tremor (only
during
performance
of highly
skilled
activities,
such as
writing or
playing a
musical
instument).
|
 |
|
please continue to next page
|
Our treatments better then Mayo clinic,
Cleveland clinic, we provide online help and information
better them mayo or Cleveland clinic |
|
|
|
|
Though prophets have stopped coming Saints
&Dervish or holy men still come. |
|
| if you got this far H202 gets rid of heart disease and cancer too. read our e.book on top of the page |
|
|
Please go to the next page
Human Brain
neurotransmitter page
Read our
healing Secrets
|
World Wide Consultation
by Internet
 |