Classification and treatment of tremor

Article Abstract:

Tremor is an involuntary movement which consists of rhythmic oscillation. There are many different forms of tremor resulting from a variety of different causes; the diagnosis, classification, and treatment of tremor are reviewed in detail. Tremor at rest, as its name implies, is tremor present in parts of the body which are neither moving nor active in maintaining posture. For all practical purposes, tremor at rest may be considered to be part of Parkinson's disease or other forms of parkinsonism. Most commonly, the tremor improves with the levodopa treatment for the parkinsonism. However, trihexyphenidyl hydrochloride may also be used. Postural tremor arises from the body's attempts to maintain posture. A tiny bit is present in everyone, but in some individuals it may increase and become a symptom; this form of tremor is called exaggerated physiological tremor. Another form of postural tremor is essential tremor, which often occurs in families and is inherited as an autosomal dominant trait. Essential tremor may also be intentional, which means that the tremor begins when the patient begins an intentional movement, in contrast with an unconscious movement. Since tremor is a part of parkinsonism, and parkinsonism results from problems in a part of the brain called the basal ganglia, it is not surprising that other conditions which affect the basal ganglia can also produce tremor. One example is Wilson's disease, which results from abnormal copper metabolism. For the tremor in Wilson's disease, there is no known treatment. Tremor may also result from damage to the cerebellum of the brain, most often as a consequence of multiple sclerosis, but strokes or tumors may often cause cerebellar tremor. Tremor may also result from peripheral nerve damage, trauma to the head, and alcoholism. It should not be forgotten, however, that tremor may result from conversion disorder as well. Also called hysterical tremor, this form of tremor results from psychiatric causes rather than physical illness and may prove difficult to accurately diagnose. (Consumer Summary produced by Reliance Medical Information, Inc.)

Identification and classification

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Essential national health research: a key to equity in development

Article Abstract:

A recently published report, Health Research: Essential Link to Equity in Development, available from Oxford University Press, has been prepared by an independent international initiative, the Commission on Health Research for Development. The report points out that only about five percent of the world's expenditures for health research are directed towards health problems of the developing nations. In terms of the years of human life prematurely lost, these developing nations account for 93 percent of the world's premature mortality. Acute respiratory infections, such as measles and whooping cough, account for the deaths of 7.4 million children each year, and diarrhea an additional 5 million. Complications of pregnancy and childbirth kill 500,000 women each year, despite the great advances that have been achieved in Western nations. The commission recognizes that dealing with these problems must involve the interaction of researchers from many fields, since the problems involve not only medicine, but social, cultural, and economic factors. The commission recommends that institutions for research and training in the developed countries take an active role in the expansion of research into the health problems of the developing countries. The commission also emphasizes that the same orientation towards essential health research for developing countries will also benefit nations like the United States. The development of a more global awareness of health issues and the need for contextually appropriate methods for dealing with health problems will help to improve public health and reduce internal disparities in the United States as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, International aspects, Medical care, Public health, World health, editorial

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Essential tremor

Article Abstract:

Primodone and propranolol are the most effective drug treatments for tremor. Benzodiazepines are also effective but there is not enough evidence to recommend nimodipine or theophylline. Electrical stimulation of parts of the brain using an implanted electrode may be necessary in patients who do not respond to medication.

Drug therapy

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