Essential tremor

Essential tremor is a disease transmitted by an autosomal dominant type of inheritance, the main symptom of which is trembling. The frequency of occurrence of essential tremor in the population is 4-55 cases per 1,000 population over 40 years.

The first signs of the disease appear at the age of 30-60 years. In many families, the disease develops at the same age. However, there is often an earlier appearance of jitter in subsequent generations. As regards jitter, the doctor is usually treated only in cases when it interferes with the work or becomes noticeable to an outsider. Initially, the tremor is weak, unstable, manifested during disturbances and physical stress, then slowly and gradually over several years it increases in intensity and becomes more or less stable in the future. Periods of relative remission may be observed, but completely shaking never disappears. The rhythm of jitter is variable, more often within 7-10 oscillations per second. Trembling is expressed with the retention of the posture( postural tremor) and persists, but does not increase with movements. Most often it is localized in the fingers and hands of the type of flexion-extension, as well as in the muscles of the neck, which is manifested by the rocking movements of the head back and forth( "yes" type of shaking).As the disease progresses, mimic muscles, vocal cords, lower jaw, tongue and( very rarely) lower limbs can be involved. Tremor disappears in a dream, decreases with distraction of attention, alcohol intake, which is considered a characteristic sign of an essential tremor. A part of people may reveal not pronounced signs of cerebellar involvement and an increase in muscle tone in the limbs. Symptoms of cerebellar involvement include: impaired coordination of movements, decreased muscle tone, violation of the correct alternation of opposing movements, excessive and disproportionate movements, a miss when trying to touch the index finger to the tip of the nose with the eyes closed.

The diagnosis of an essential tremor does not raise any doubts in case of presence of the following characteristic signs in a person:

1) autosomal dominant type of disease inheritance;

2) the appearance of the first signs of the disease at the age of 30-60 years;

3) postural tremor retained during movements;

4) absence of other signs of damage to the nervous system;

5) absence of structural changes in brain tissue during computer and magnetic resonance imaging;

6) positive results in DNA testing.

Treatment. For the treatment of essential tremor, the following drugs are used: anaprilin( at a dose of up to 120 mg / day), clonazepam( antelepsin), clonidine( clonidine at a dose of 0.1-0.9 mg per day), akinetone or cyclodol, vitamin B6, nootropicspiracetam, encephabol), sedatives( soothing).In any case, this disease treatment is appointed only by a neurologist after carrying out all the necessary studies. If the treatment is ineffective in cases of severe tremor, surgical treatment is sometimes performed. However, such an operation is extremely difficult, since it affects the structure of the brain. In this regard, such treatment is possible only in highly specialized and equipped with the latest technology medical centers.