26 June 2020 Author : Ana Calado The tremor is an involuntary rhythmic and oscillatory movement of a part of the limbs, trunk, head, face, or vocal cords. Tremor can be physiological , when not visible, or it is only visible when is increased by fatigue or anxiety and occurs in healthy people; It is pathological when it is visible and persistent, and can be a primary disease (for example essential tremor) or secondary to other diseases; Are there different types of tremor? Tremor is classified into several types based on its characteristics: Resting tremor , which is visible at rest when a part of the body is fully supported against gravity; Action tremor , which is maximum when a part of the body moves voluntarily, and can have two types: Postural tremor , which reaches a peak when a limb is held in a fixed position against gravity. Intention tremor , which reaches a peak when during an involuntary movement towards a target, is the target is reached. Postural tremor is common in a disorder called essential tremor, but it can also be associated with anxiety, consumption of caffeine, alcohol or some medications; it may also be present in some diseases, for example hyperthyroidism or hyperparathyroidism. In Parkinson's disease , resting tremor is the most frequent. Intention tremor is usually associated with dysfunction of the cerebellum and may be secondary to stroke, trauma, or multiple sclerosis. How is tremor diagnosed and treated? The diagnosis of tremor is clinical, based on the observation of its characteristics by a specialized physician. It may be necessary to perform some additional diagnostic tests to rule out diseases that are associated with tremor. There are situations associated with tremor that may be related to other diseases, in which it is essential to quickly seek observation by a specialist, for example: Sudden acute onset of tremor; Fast progression; Association of tremor with other neurological symptoms; Tachycardia (palpitations) and agitation associated with tremor. The treatment of tremor depends on the type of tremor and its causes. It may be necessary to make changes in lifestyle or stop medication that aggravates or causes tremor. When associated with other diseases, the treatment of tremor depends on the disease in question. For example, in the tremor in Parkinson's disease the treatment involves antiparkinsonian medication, in the tremor of a thyroid disease by the treatment of that condition. Essential tremor Essential tremor is a disease that presents isolated tremor, usually of action and posture, bilateral of the upper limbs, and can also reach the lower limbs, the head, and the voice. The disease affects 1% of the population and its frequency increases with age. Usually, symptoms aggravate slowly with advancing age. Although the cause of essential tremor is still unknown, it is believed that there are genetic factors involved, since there are often relatives with tremor. Essential tremor is considered a benign tremor . Although it may have an impact on activities of daily living, it does not usually alter average life expectancy. The treatment of essential tremor can be done with several drugs that do not cure the disease but can improve symptoms. In rare cases, when symptoms are disabling and do not improve with medication, deep brain stimulation surgery may be considered. Meet the neurology team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
