TREMBLING

A tremor is defined as a rhythmic involuntary (uncontrolled by the person) movement of a part of the body. Usually it's the hands or the feet or the head or both. It can appear when the hand is calm, when we raise it in the air, when we do something
specific act with it. It can get worse with stress or in front of people. The most common thing someone thinks when they experience a tremor in their hand is that they are suffering from Parkinson's Disease. But things are not that simple. This tremor can also be due to a disease called Idiopathic tremor, dystonia, cerebellar diseases, a stroke or be a side effect of some medications the patient is taking. Separating these neurological conditions is often quite difficult and requires a complete neurological examination, laboratory tests and perhaps some imaging of the brain (eg CT scan). Only after an evaluation by the neurologist and after the necessary tests should the patient start medication for his tremor and for the illness, because there is a possibility that the medication taken by a wrongly diagnosed patient could worsen his condition.

PARKINSON'S DISEASE

Parkinson's disease is a neurodegenerative disease that usually presents, in addition to tremors and stiff limbs ("jabbed hands"), walking difficulties, balance difficulties and, in general, a slowness of movements. There is also usually a specific face. In classic Parkinson's disease, dementia or hallucinations do not appear in the early stages. The disease is NOT hereditary (except in very rare cases), but can sometimes start at a young age (35-45 years old). There is now a plethora of drugs that the neurologist can use to treat the disease. From levodopa (dopamine), which is the substance missing in the brain, to dopamine antagonists and other drugs. Also the forms that the new drugs have, e.g. 24-hour patch or once-a-day slow-release pills have greatly improved their ease of administration and patient compliance. Most important for this chronic disease is to establish a chronic relationship between the neurologist and the patient because the treatment will be modified slowly but surely over the years for optimal results.

IDIOPATHIC TERROR

Idiopathic tremor is a disease more common than Parkinson's Disease, which unfortunately is often confused with it and the patient may receive the wrong medication for years.

The disease is hereditary and often begins at an early age. In cases where the patient will need to receive some medication from the treating neurologist, there is usually a good response.