How To Deal With Tremor Flashcards

1
Q

What are the 2 types of tremor

A

Rest

Action

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2
Q

What can action tremor be further divided into

A

Postural
Isometric
Kinetic

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3
Q

What is a resting tremor

A

A tremor that occurs at rest

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4
Q

What is postural tremor

A

Occurs when a limb is held against gravity

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5
Q

What is kinetic tremor

A

Occurs when you direct a voluntary movement of the affected body e.g when asking to pick up an object

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6
Q

What is a isometric tremor

A

When there is sustained muscle contraction agaisnt an object e.g pressing your hand against the table

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7
Q

What is an essential tremor

A

The commonest tremor disorder

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8
Q

What are the feautes of essential tremor

A

Occurs in mid to late adolence
Can be familial therefore ask about family history
Bilateral, symmetrical postural hand tremor
Can also affect jaw, voic, head and legs
Affects holding objects
Improves with alcohol

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9
Q

What is the diagnosis of essential tremor by

A

History and findings

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10
Q

What is the tratment of essential tremor

A

Beta blockers

If beta blockers are not tolerated use primidone or alprazaolom

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11
Q

In parkinsons disease what type of tremor do they present with

A

Resting tremor

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12
Q

What is parksinsons disease caused by

A

Degeneration of the substantia niagra in the midbrain and there are deposition of lewy bodies

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13
Q

What are the symptoms of parkinsons disease

A

Unilateral rest tremor
Bradykinesia (slowliness)
Rigidity
Postural instability

Depression, anxiety
Constipation
Sleep disturbance
Urinary symptoms 
Hallucination
Cognitive impairment or dementia
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14
Q

What is the treatment of parkinsons disease

A
L-dopa (precursor of dopamine)
Decarboxylase inhibitors
COMT inhibitors 
MOA inhibitors
Dopamine agonist
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15
Q

Why is decarboxylase inhibitors used

A

To stop l dopa from being converted into dopamine in the gut

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16
Q

Why are COMT inhibitors used

A

To stop COMT from breaking down L-dopa to 3MT in the brain

17
Q

Why are MOA inhibitors used

A

To stop doapmine from being converted to DOPAC

18
Q

Whast is the complication of using L-dopa

A

They can develop on and off symptoms i.e fluctuations

19
Q

What are the alternative treatmetn for dyskinesia in parksinsons

A

Amantadine

20
Q

What are the treatment for severe motor fluctuations in parkinsons disease

A

Apomorphine

21
Q

What is a orthostatic tremor/ shaky leg

A

High frequency tremor of the leg and appears on standing

22
Q

What is a dystonic tremor

A

Tremor that occurs at rest with posture and can be kinetic

23
Q

What is a cerebellar tremor

A

Irregular low frequency tremor that affects the head, trunk and limbs

24
Q

What are the causes of cerebellar tremor

A

Posteriori circualtion stroke
Neurodegenerative disease
Multiple sclerosis
Drugs- alcohol and anti-epileptics

25
Q

What is a holmes tremor

A

Low frequency, postural and intention tremor

26
Q

What are the causes of holmes tremor

A

Stroke
Trauma
Vascular malformation
Tumour