Tremor Myoclonus etc

Question 1

involuntary rhythmic oscillatory movement produced by alternating or irregularly synchronous contractions of reciprocally innervated muscles

Answer 1

tremor

Question 2

present in all contracting muscle groups and persists throughout the walking state and in certain phases of sleep
so fine that it can barely be seen by the naked eye
between 8-13 Hz, dominant 10Hz

Answer 2

Physiologic tremor

Question 3

enhancing and attenuating agents for physiologic tremors

Answer 3

enhancing: epinephrine, B adrenergics
attenuating: alcohol, B adrenergic antagonists

Question 4

evident during use of affected body part

Answer 4

action tremors

Question 5

two categories of action tremors

Answer 5

goal directed

postural

Question 6

occurs with the limbs and trunk actively maintained in certain positions
absent when limbs are relaxed, evident when muscles are activated

Answer 6

postural

Question 7

most common type of tremor
4-8Hz
inheritance is autosomal dominant appears in 2nd decade, may begin in childhood and persist
2nd peak in pts older than 35

Answer 7

essential tremor

usually symmetrical
15% may appear first in dominant hand
tremor may remain limited to upper limbs or side to side or nodding movement of head
there may be tremor of chin

Question 8

treatment of essential tremor

Answer 8

propranolol 80-200mg per day in divided doses

benefit is variable and incomplete

Question 9

side effects propranolol

Answer 9

fatigue, erectile dysfunction, bronchospasm