How To Deal With Tremor Flashcards
What are the 2 types of tremor
Rest
Action
What can action tremor be further divided into
Postural
Isometric
Kinetic
What is a resting tremor
A tremor that occurs at rest
What is postural tremor
Occurs when a limb is held against gravity
What is kinetic tremor
Occurs when you direct a voluntary movement of the affected body e.g when asking to pick up an object
What is a isometric tremor
When there is sustained muscle contraction agaisnt an object e.g pressing your hand against the table
What is an essential tremor
The commonest tremor disorder
What are the feautes of essential tremor
Occurs in mid to late adolence
Can be familial therefore ask about family history
Bilateral, symmetrical postural hand tremor
Can also affect jaw, voic, head and legs
Affects holding objects
Improves with alcohol
What is the diagnosis of essential tremor by
History and findings
What is the tratment of essential tremor
Beta blockers
If beta blockers are not tolerated use primidone or alprazaolom
In parkinsons disease what type of tremor do they present with
Resting tremor
What is parksinsons disease caused by
Degeneration of the substantia niagra in the midbrain and there are deposition of lewy bodies
What are the symptoms of parkinsons disease
Unilateral rest tremor
Bradykinesia (slowliness)
Rigidity
Postural instability
Depression, anxiety Constipation Sleep disturbance Urinary symptoms Hallucination Cognitive impairment or dementia
What is the treatment of parkinsons disease
L-dopa (precursor of dopamine) Decarboxylase inhibitors COMT inhibitors MOA inhibitors Dopamine agonist
Why is decarboxylase inhibitors used
To stop l dopa from being converted into dopamine in the gut
Why are COMT inhibitors used
To stop COMT from breaking down L-dopa to 3MT in the brain
Why are MOA inhibitors used
To stop doapmine from being converted to DOPAC
Whast is the complication of using L-dopa
They can develop on and off symptoms i.e fluctuations
What are the alternative treatmetn for dyskinesia in parksinsons
Amantadine
What are the treatment for severe motor fluctuations in parkinsons disease
Apomorphine
What is a orthostatic tremor/ shaky leg
High frequency tremor of the leg and appears on standing
What is a dystonic tremor
Tremor that occurs at rest with posture and can be kinetic
What is a cerebellar tremor
Irregular low frequency tremor that affects the head, trunk and limbs
What are the causes of cerebellar tremor
Posteriori circualtion stroke
Neurodegenerative disease
Multiple sclerosis
Drugs- alcohol and anti-epileptics
What is a holmes tremor
Low frequency, postural and intention tremor
What are the causes of holmes tremor
Stroke
Trauma
Vascular malformation
Tumour
