What causes hand tremors? Is it Parkinson's disease?

Author: Chen Haibo, chief physician of Beijing Hospital

Reviewer: Hu Wenli, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

When talking about hand tremors, many people think of Parkinson's disease.

Does hand tremor necessarily mean Parkinson's disease? What is the difference between Parkinson's disease and Parkinson's syndrome? Let's learn about it together.

1. What causes hand tremors? Is it definitely Parkinson's disease?

There are many reasons for hand tremors, and one common reason is essential tremor, also known as essential tremor.

Essential tremor is often related to heredity. About 50% to 60% of patients have a family history, which means it is hereditary. Another 40% to 50% cannot find a clear cause. Essential tremor is often more common in the elderly, but it can also occur in younger people.

The tremor caused by Parkinson's disease is called resting tremor, which occurs when the muscles are relaxed. For example, if you place your hands lightly on the table, you will experience shaking.

Essential tremor is a postural or movement tremor that occurs only under certain posture conditions, such as when you raise your hands upright or stretch them out, or when you use chopsticks to pick up food or drink water from a cup.

Figure 1 Original copyright image, no permission to reprint

Because this tremor occurs in certain movements or postures, including some patients will feel the head shaking, this shaking must be when standing or sitting, when the neck supports the head. If you lie in bed and are in a completely relaxed state, there will be no tremor, which is also a postural tremor.

In addition, essential tremor does not cause slow movements, muscle stiffness, or postural balance disorders, so these are two different diseases. However, the chance of patients with essential tremor developing Parkinson's disease is about 4 times higher than that of people without essential tremor.

Of course, there are other causes of tremor, such as hyperthyroidism, which can cause compensatory or physiological tremor enhancement, and tremors when doing certain movements, but there is no slowness of movement. Therefore, for patients with tremor onset, we often perform thyroid function tests in the early stages of the disease to rule out this disease.

2. Are Parkinson's disease and Parkinson's syndrome the same thing?

Parkinson's syndrome is a neurological disease. Generally speaking, it has two concepts, one is relatively broad and the other is relatively narrow.

Parkinson's syndrome in a broad sense refers to any disease with the three symptoms of resting tremor, bradykinesia, and muscle rigidity. There are many such diseases.

For example, primary Parkinson's disease is one of the most common Parkinson's syndromes, which often occurs in the elderly. The reason why it is called primary is that our current medical level has not yet figured out its cause.

For example, Parkinson's plus syndrome, in addition to the three symptoms mentioned above, may also have cerebellar symptoms, such as gait disorders, that is, unsteady walking, like being drunk, and even urinary incontinence, dizziness when standing, low blood pressure and other symptoms.

For example, secondary Parkinson's syndrome often has clear causes. For example, some patients with cerebrovascular disease have slow movements, stiffness, and unsteady gait, just like Parkinson's disease. Brain inflammation, drugs, drug poisoning, or genetics can also cause symptoms similar to Parkinson's disease, and these are all secondary.

Parkinson's syndrome in a narrow sense does not include primary Parkinson's disease, but only includes Parkinson's plus syndrome and secondary Parkinson's syndrome.

Figure 2 Original copyright image, no permission to reprint

3. How to prevent the occurrence of Parkinson’s disease?

So far, the cause of Parkinson's disease has not been fully understood. Some are related to genetics, but for middle-aged and elderly people, it is difficult to find a clear genetic gene. In addition, the older you are, the higher the incidence rate, so it is also related to aging. Genetic inheritance and aging are two factors that we cannot control.

In addition, the occurrence of Parkinson's disease is related to environmental toxins, which we can control. For example, paraquat in herbicides has been clearly shown in animal experiments to cause Parkinson's disease-like symptoms in animals. In addition, rotenone in pesticides can also damage dopaminergic neurons. Therefore, if you use these two drugs, you must take precautions.

Of course, there are some other rare chemicals, one of which is called 1-methyl-4-phenyl-1-2-3-6-tetrahydropyridine, which can specifically damage dopaminergic neurons and cause Parkinson's-like manifestations.

So first, we should try to reduce our exposure to these toxins, including some unknown toxins. Second, regular exercise may also reduce the risk of Parkinson's disease or delay the onset of the disease. Third, a balanced diet may also be a way to reduce the incidence of Parkinson's disease.