Approach to a tremor patient
Tremors are commonly encountered in clinical practice and are the most common movement disorders seen. It is defined as a rhythmic, involuntary oscillatory movement of a body part around one or more joints. In the majority of the population, tremor tends to be mild. They have varying etiology; hence...
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doaj-951b546ad9564bcd95879f973623a09b2020-11-24T22:09:28ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492016-01-0119443344310.4103/0972-2327.194409Approach to a tremor patientSoumya SharmaSanjay PandeyTremors are commonly encountered in clinical practice and are the most common movement disorders seen. It is defined as a rhythmic, involuntary oscillatory movement of a body part around one or more joints. In the majority of the population, tremor tends to be mild. They have varying etiology; hence, classifying them appropriately helps in identifying the underlying cause. Clinically, tremor is classified as occurring at rest or action. They can also be classified based on their frequency, amplitude, and body part involved. Parkinsonian tremor is the most common cause of rest tremor. Essential tremor (ET) and enhanced physiological tremor are the most common causes of action tremor. Isolated head tremor is more likely to be dystonic rather than ET. Isolated voice tremor could be considered to be a spectrum of ET. Psychogenic tremor is not a diagnosis of exclusion; rather, demonstration of various clinical signs is needed to establish the diagnosis. Severity of tremor and response to treatment can be assessed using clinical rating scales as well as using electrophysiological measurements. The treatment of tremor is symptomatic. Medications are effective in half the cases of essential hand tremor and in refractory patients; deep brain stimulation is an alternative therapy. Midline tremors benefit from botulinum toxin injections. It is also the treatment of choice in dystonic tremor and primary writing tremor.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2016;volume=19;issue=4;spage=433;epage=443;aulast=SharmaBotulinum toxindeep brain stimulationessential tremorhead tremorParkinson diseasetremortremor rating scales |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Soumya Sharma Sanjay Pandey |
spellingShingle |
Soumya Sharma Sanjay Pandey Approach to a tremor patient Annals of Indian Academy of Neurology Botulinum toxin deep brain stimulation essential tremor head tremor Parkinson disease tremor tremor rating scales |
author_facet |
Soumya Sharma Sanjay Pandey |
author_sort |
Soumya Sharma |
title |
Approach to a tremor patient |
title_short |
Approach to a tremor patient |
title_full |
Approach to a tremor patient |
title_fullStr |
Approach to a tremor patient |
title_full_unstemmed |
Approach to a tremor patient |
title_sort |
approach to a tremor patient |
publisher |
Wolters Kluwer Medknow Publications |
series |
Annals of Indian Academy of Neurology |
issn |
0972-2327 1998-3549 |
publishDate |
2016-01-01 |
description |
Tremors are commonly encountered in clinical practice and are the most common movement disorders seen. It is defined as a rhythmic, involuntary oscillatory movement of a body part around one or more joints. In the majority of the population, tremor tends to be mild. They have varying etiology; hence, classifying them appropriately helps in identifying the underlying cause. Clinically, tremor is classified as occurring at rest or action. They can also be classified based on their frequency, amplitude, and body part involved. Parkinsonian tremor is the most common cause of rest tremor. Essential tremor (ET) and enhanced physiological tremor are the most common causes of action tremor. Isolated head tremor is more likely to be dystonic rather than ET. Isolated voice tremor could be considered to be a spectrum of ET. Psychogenic tremor is not a diagnosis of exclusion; rather, demonstration of various clinical signs is needed to establish the diagnosis. Severity of tremor and response to treatment can be assessed using clinical rating scales as well as using electrophysiological measurements. The treatment of tremor is symptomatic. Medications are effective in half the cases of essential hand tremor and in refractory patients; deep brain stimulation is an alternative therapy. Midline tremors benefit from botulinum toxin injections. It is also the treatment of choice in dystonic tremor and primary writing tremor. |
topic |
Botulinum toxin deep brain stimulation essential tremor head tremor Parkinson disease tremor tremor rating scales |
url |
http://www.annalsofian.org/article.asp?issn=0972-2327;year=2016;volume=19;issue=4;spage=433;epage=443;aulast=Sharma |
work_keys_str_mv |
AT soumyasharma approachtoatremorpatient AT sanjaypandey approachtoatremorpatient |
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