Symptoms of essential tremor, these manifestations are most common

Essential tremor is a hereditary disease and a chromosomal abnormality. It is common in adult males. The chance of developing the disease increases with age. The most obvious manifestation is tremor in the upper limbs, which then develops to tremor in the face and head.

1. Typical essential tremor can be found in children, adolescents, middle-aged and elderly people . There are two views on the peak age of onset. One view is that the distribution of age of onset has a bimodal characteristic, that is, in the two age groups of 20-30 years old and 50-60 years old; another view is that essential tremor rarely occurs in teenagers, and the number of cases increases with age, with an average onset age of 37 to 47 years old.

2. The only symptom of essential tremor is tremor , which is occasionally reported to be accompanied by abnormalities in voice tone and slight gait. Patients usually start with the upper limbs, which are mainly affected. The disease may start symmetrically on both sides or unilaterally. Once the upper limbs are affected, the disease often spreads upward to the head, face, tongue, and mandible. Involvement of the trunk and bilateral lower limbs is rare and only occurs in the late stage of the disease, and the degree is milder than that of the upper limbs.

The main manifestation is postural tremor, which may also contain kinetic, intention or resting tremor components. The tremor may be worse during directed movements. The frequency of tremor is 4 to 8 Hz. The frequency at onset is 8 to 12 Hz. With the course of the disease and age, the frequency gradually decreases and the amplitude gradually increases.

The typical symptoms are rhythmic abduction of the hands, adduction-like tremors and flexion-extension-like tremors. Pronation-supination tremors (similar to Parkinson's disease) are very rare. The written words may be deformed, but they will not appear to be too small. Another area commonly affected is the craniocervical muscles. The head, tongue, or vocal muscles may be affected, manifesting as severe postural tremor in the patient's hands and head tremor, including vertical "nodding" movements and horizontal "shaking" movements. Tremors of the soft palate and tongue can cause difficulty in speaking.

3. Tremor will affect activities 10 to 20 years after onset, and its severity will increase with age, so that the ability to complete fine movements is impaired, reaching a peak in the sixth decade after onset. 86% of patients may have social activities and living abilities affected by the age of 60 to 70, including writing, drinking, eating, dressing, speech and operation. The larger the tremor, the greater the impact on mobility. There was no difference in the effects of tremor between the sexes.

4. Many factors can affect tremors . Hunger, fatigue, emotional excitement and temperature (high fever, hot bath) can aggravate tremors. Like most involuntary movements, essential tremor improves during sleep, but there are also individual reports that tremor persists during light sleep.

The response of patients with essential tremor to ethanol (alcohol) is characteristic. For many patients, tremors can be reduced by ingesting even small amounts of ethanol (alcohol). In 42% to 75% of patients, tremors are relieved after drinking, but this is only temporary, generally lasting 2 to 4 hours, and the tremors will worsen the next day. There are few reports that ethanol (alcohol) has similar effects on other types of tremor. Ethanol (alcohol) acts through the central nervous system.