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Not all tremors are Parkinson's: why they can occur and when to consult

2023-01-19T09:34:51.657Z


The body can experience involuntary movements for multiple causes. Why the body can experience tremors? Is it something typical of age, or can it happen at any time? Are involuntary movements always Parkinson's? Or can they be  a sign of something else ? There are many concerns that appear when talking about tremors, associated above all with Ramiro Heredia, a clinical doctor at the Hospital de Clínicas. And he adds: "They can be an isolated entity, or be part


Why the body can experience tremors?

Is it something typical of age, or can it happen at any time?

Are involuntary movements always Parkinson's?

Or can they be 

a sign of something else

?

There are many concerns that appear when talking about tremors, associated above all with Ramiro Heredia, a clinical doctor at the Hospital de Clínicas.

And he adds: "They can be an isolated entity, or be part of a disease."

Tremors: what are they and what types are there

"The tremor is defined as the movement of a part of the body in an

involuntary and rhythmic way.

It is caused by the contraction of antagonistic muscles, both synchronously and alternately. Generally, it affects the hands or the head, although it can affect the any part of the body", describes the doctor.


Meanwhile, Ricardo Maiola, a neurologist from the Parkinson's and Abnormal Movements Program of the same institution, specifies: "Tremors are very frequent abnormal movements in daily life, they are divided into two large groups:

physiological and pathological

. The difference is in that the latter can alter daily activities, while the former are those that are present from a very early age, and do not represent a problem".

The neurologist explains that, in turn, pathological tremors are divided into

three large groups:

those

of rest

(when the body is not moving, relaxed),

postural

(for example, if it appears when the hands are extended or a certain activity such as grasping an object), and the

intentional

(occurs before a certain action, such as when the tip of the nose is touched with the index finger).

Heredia adds: "It can also be classified

according to its distribution

, that is, according to which part of the body it affects, if it is localized (for example, in the hand) or generalized, and if it is symmetrical (it affects both halves of the body equally). ) or asymmetrical (affects one half of the body more than the other)".

If they persist without apparent cause, a doctor should be consulted.

Photo Shutterstock.

Causes of tremors

As indicated, tremors can be physiological (that is, they occur in a healthy person, without disease), to be caused by a wide

variety

of diseases, medications, substances or toxic agents, among other causes.

The most common tremors are seen

in the hands

, although they can affect the head, legs, trunk, vocal cords, and any part of the body.

"They can be of genetic origin, that is, the person who suffers from it has a father or a mother with the same condition; acquired; or even idiopathic, without a clear cause that justifies it," lists Heredia.

However, it is important to know that, if they recur over time without a clear or apparent cause, it is convenient

to consult the family doctor

, clinician, family doctor or general practitioner, "so that they can evaluate the tremors with a holistic vision," he recommends.

"Tremors need to be assessed in a

clinical context

," he suggests.

And although he clarifies that it is not necessary in all cases: "After the clinical examination, some patients are indicated to consult a neurologist."

Tremors can be at rest or action.

Photo Shutterstock.

Tremors: what can they be a symptom of?

Although it is difficult to generalize, Heredia lists what tend to be the most common

underlying diseases

.

The most common cause of action tremor (that is, the tremor that is not resting) is when for some reason the so-called

"normal body tremor"

is exacerbated .

"We all have a tremor that is physiological, imperceptible, but in certain situations, such as exposure to drugs, drugs, alcohol, caffeine, inhalation medications such as salbutamol, which is used to treat asthma attacks, states of anxiety, fear, tiredness , or hormonal disorders such as hyperthyroidism, fever;

it becomes evident

and sometimes leads to medical consultation," he lists.

Coffee, alcohol or drugs can enhance a natural and imperceptible tremor.

Photo Shutterstock.

However, action tremor can also have a pathological cause: "These are people who suffer from

essential

or benign tremor. Indeed, this can affect up to

5% of the population

, generally from 30-40 years of age , many with a father or mother with the same condition", he specifies. 

It is not related to Parkinson's disease and, in fact, benign tremor is

4 times more frequent

than that disease, since the prevalence is 3 to 4 cases per thousand inhabitants per year.


Maiola indicates that essential or benign tremor is the most frequent pathological cause of action tremor and that it has a "partial response" to a large number of medications that can be indicated to treat it.


Parkinson's disease

However, as Maiola explained, the most frequent cause of

tremor at rest

is indeed Parkinson's disease.

Its prevalence is

1 case per thousand inhabitants

per year, says Heredia.

"It is the

most frequent cause of tremor at rest

, and it is one of the phantoms of patients who suffer from tremors. It is accompanied by other clinical signs, such as slowing of movement (bradykinesia), rigidity, and instability of the posture," he explains.

For its diagnosis, "the main thing is

medical evaluation

", he insists, since there is no imaging or laboratory test that by itself allows the detection of Parkinson's disease, but rather it is diagnosed using different clinical criteria, always ruling out other causes. for symptoms, such as the use of drugs.

However, to support the diagnosis, "many patients will need laboratory tests, imaging of the nervous system and sometimes functional tests," he adds.

Tremors: when to consult

"It is always necessary to consult before tremors, whether it represents a disease or not, because if it appears at some point in life that did not exist before, it

forces us to rule out some underlying disease

, or that the tremor is the cause of all the discomfort, as it is the case of essential tremor", indicates the neurologist. 


"A medical history and a meticulous physical examination must be done. It is also taken into account how well it responds to certain treatments," concludes Heredia.

***

Do you want to read more about Parkinson's disease?

These notes may interest you:

➪Alzheimer's and Parkinson's: how language can help detect the first clues

➪Nightmares as an early symptom of Parkinson's: what types of dreams can appear and since when

➪Parkinson's, in the first person: "It affects my being, but not my doing"

➪An approach to "Mr. Parkinson" through the experience of Indio Solari


***

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Source: clarin

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