Monday, June 22, 2020

Is shaking hands Parkinson's disease?

Parkinson's disease is a progressive neurodegenerative disease. About 70%-75% of patients start with tremor, and hand shaking is the common first symptom. Because there is no cure for Parkinson's disease, the symptoms are diverse. The late stage of the disease often causes patients to lose their ability to work and live on their own. People are afraid of Parkinson's disease and talk about "Parker" discoloration. So once I found myself shaking, I started to feel nervous and anxious. So is it all Parkinson's disease?

Hand shaking is medically called tremor, which is mainly manifested as involuntary rhythmic tremor of the hand. Hand shaking is divided into physiological hand shaking and pathological hand shaking. Among them, physiological hand shaking will be experienced in each of our lives, often appearing under conditions of nervousness, fear, emotional excitement, severe pain and extreme fatigue. For example, when we are nervous, we will shake hands involuntarily, or even legs; when we are extremely angry, we will say "shaking with anger"; when we are hungry, we will feel panicky and hand shaking... The characteristic of physiological hand shaking is amplitude Small and fast, once the above causes of hand shaking are eliminated, the hand shaking will also disappear.

We are worried about pathological hand shaking. What are the common pathological hand shaking?

1. Hand shaking caused by hyperthyroidism: Hyperthyroidism is most common in young women and is a disease caused by excessive thyroid hormone secreted by the thyroid. The four main symptoms of hyperthyroidism are panic shaking hands, fear of heat and sweating, hungry eating, and weight loss. Patients with hyperthyroidism often suspect that they are "Parkinson's disease" or "neuropathy" because of hand shaking. The doctor will check the patient's thyroid function or thyroid color Doppler ultrasound based on the patient's age and accompanying symptoms, and the results will be clear at a glance.

2. Hand shaking caused by cervical spondylosis: With the increase of age and people's dependence on computers and mobile phones in modern society, the age of onset of cervical spondylosis shows a younger trend. Cervical spondylopathy is divided into cervical cervical spondylosis, nerve root cervical spondylosis, spinal cervical spondylosis, and vertebral artery cervical spondylosis. Among them, cervical cervical spondylosis is mainly caused by prolonged bowing of the head, repeated certain postures, and colds, which causes muscle spasm, stiffness, and limited movement of the neck, which in turn causes muscle tension in the upper limbs, resulting in difficulty in hand movements and hand shaking. Cervical spondylotic radiculopathy is caused by spinal stenosis that compresses the cervical nerve roots, resulting in abnormal discharge of the nerves that dominate the hands and causing hand shaking. Cervical spondylotic myelopathy is caused by cervical spinal cord compression or spinal cord blood circulation disorder, which may be accompanied by difficulty in completing fine movements of the upper limbs, and may also cause hand shaking. After excluding other causes of hand shaking, CT or nuclear magnetic examination of the cervical spine can be performed to determine whether there is hand shaking caused by cervical spondylosis.

3. Hand shaking caused by idiopathic tremor: Idiopathic tremor is also known as primary tremor and familial tremor. About 60% of patients have a family history. The occurrence of tremor usually starts with symmetry on both sides. It is more common with the hand as the starting part, and some parts start with the head. It can also affect the tongue. Progression of the lesion will gradually affect the legs or torso, but rarely starts from the legs. Idiopathic tremor is usually aggravated when concentration, nervousness, fatigue, hunger, or certain specific actions, such as holding a water glass, picking vegetables, tying shoelaces, is medically called action tremor. The frequency of vibration is usually 8-12Hz (ie 8-12 times per second). Most cases disappear temporarily after drinking alcohol and worsen the next day, which is also a clinical feature of idiopathic tremor. The study found that the probability of patients with idiopathic tremor over 65 years of age progressing to Parkinson's disease will increase 3-4 times, so we should also pay attention to it.

4. Hand shaking caused by Parkinson's disease: Hand shaking in patients with Parkinson's disease is well known and is usually the first symptom. It also has a special term called "pill-like action", that is, the action of shaking the thumb and flexed index finger like rubbing a pill. Its characteristic is that it appears or is obvious when it is still. It can temporarily control but not last for consciousness. It stops or reduces when it is active, increases when it is tired, agitated, nervous, or anxious, and disappears after falling asleep. The tremor usually starts from the distal end of one upper limb and then gradually expands to the lower limb on the same side and the upper and lower limbs on the opposite side. The lower jaw, lips, tongue and head can be affected, with a frequency of 4-6 Hz (ie 4-6 times per second). Accompanying Parkinson's disease is hand tremor, muscle rigidity, slow movement, and abnormal posture. Of course, in addition to Parkinson's disease, hand shaking, Parkinson's syndrome, Parkinson's superposition syndrome will have similar symptoms. If this kind of hand shaking occurs, please go to the Parkinson's disease clinic immediately.

5. Hand shaking caused by cerebellar lesions: Hand shaking caused by cerebellar lesions is often accompanied by cerebellar ataxia, such as poor coordination of the limbs, balance dysfunction, and poor discrimination. This kind of hand shaking is called intentional tremor, which is characterized by no tremor at rest and at the beginning of limb movement, and a coarse tremor when the action is close to the target. The frequency is generally 2-4 Hz (that is, 2-4 times per second). For example, when the patient is preparing to drink water, the closer the hand is to the drinking glass, the greater the shaking. Intentional tremor is caused by antagonism of muscle coordination dysfunction, which is commonly seen in the cerebellum and its outgoing pathways, and is seen in many neurological diseases.

Other diseases such as hepatolenticular lesions, hepatic encephalopathy, drugs, poisoning, dementia, etc. can cause symptoms of hand shaking. Regardless of the cause of hand shaking, when we are not sure that it is physiological hand shaking, we must seek medical treatment in a timely manner as soon as possible, and let the doctor help you determine the cause of hand shaking. Early detection, early treatment, and early intervention of many diseases are the key to controlling disease progression. Especially for diseases that cannot be cured, such as Parkinson's disease, early and reasonable interventions are beneficial to the overall prognosis of the disease.

No comments:

Post a Comment