• Title/Summary/Keyword: Orthostatic tremor

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Pathophysiology of orthostatic tremor: a multiple case study (길입성 진전의 병태생리: 다증 증례 연구)

  • Seo, Man-Wook;Lee, Kwang-Woo
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.44-50
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    • 2002
  • Introduction : Orthostatic tremor develops in the legs while standing up with no weakness, pain or imbalance in the leg and the tremor is characteristically not observed when walking. However there have been some confusions about orthostatic tremor in several aspects. For the past ten years, we have observed 4 patients with orthostatic tremor. In each case tests were performed to investigate the following three important areas of inquiry about orthostatic tremor. Firstly, whether this disorder is an independent diagnostic entity or a variant of essential tremor. Secondly, whether the progress of this disorder is specifically related with standing posture. Lastly, the nature of the pathophysiologic mechanism behind the appearance of the tremor when standing after the lapse of a certain latent period and its disappearance upon the commencement of walking. Methods : Our 4 cases of orthostatic tremor were studied clinically, electrophysiologically, and pharmacologically. Electrophysiological tests included tremor spectrum test and electromyography. Results : We observed the presence of this tremor in several other tonic postures, as well as its absence, in a vertically lifted position from all our cases. Our cases registered a variable tremor frequency between 5 and 12 Hz according to the tremor spectrum test and EMG. Furthermore all our 4 cases demonstrated patterns of both synchronous EMG activity and alternating EMG activity at various times in homologous muscles of both legs. Orthostatic tremor was improved significantly with propranolol as well as clonazepam. Conclusions : From the results of our study we drew the following conclusions. It is probable that orthostatic tremor is simply a variant of essential tremor rather than being an independent diagnostic entity and that in most cases its development is specifically related with muscle contraction rather than merely with the act of standing. Furthermore we discovered a clue in the previously described neural control mechanism that the nuclear bag fibers in the muscle spindle have lag time of several seconds in their response to muscle strength and that their baseline does not reset fully in rapidly moving muscle. This neural control mechanism could offer sufficient explanation for the phenomena of tremor appearance when standing and disappearance when walking in orthostatic tremor.

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A Case Report of a Tremor Patient with Stenosis of the Left Carotid Artery (머리 떨림 환자에 대한 한방 치험 1례)

  • Park, Seo-hee
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.1096-1100
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    • 2017
  • The carotid artery is one of the main vessels supplying blood to the brain. Carotid artery stenosis is mostly caused by atherosclerosis, a disease where cholesterol is deposited in the arterial blood vessels. Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many diseases, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy, and alcohol withdrawal. Tremors may be classified as postural, rest, and action tremors. Tremor of a patient with stenosis of the left carotid artery decreased with acupuncture treatment. The acupoints were GB20, TE17, GV8 and GV11. This case shows that the acupuncture treatment is effective against tremor.

Four Cases of Tremor Treated with Yanghyulgupungtang-gamibang (양혈구풍탕가미방(養血驅風湯加味方)으로 호전된 진전 환자 4례에 대한 증례 보고)

  • Kim, Hong-Joon;Kim, Woo-Sung;Park, Hyoung-Jin;Cho, Chang-Hyun;Won, Jin-Hee;Kim, Yu-Kyung
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.391-400
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    • 2004
  • Tremor is a rhythmic and involuntary muscular contraction characterized by oscillations of a part of the body. Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. The appropriate treatment of tremor depends on accurate diagnosis of it's cause. Some tremors respond to treatment of underlying conditions. Senile tremor and Parkinson's tremor are more common in aged people. Yanghyulgupung-tang is effective herbal medication in blood deficiency-type senile tremor. Four cases of senile tremor and Parkinson's tremor are reported. All four patient were treated with Yanghyulgupungtang-gamibang and improvement was seen in all four.

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A Case Study of a Taeeumin Patient with Advanced Parkinson's Disease Having Orthostatic Hypotension (기립성 저혈압이 있는 진행된 파킨슨병 태음인 환자 치험 1례)

  • Lee, Mi-Suk;Park, Yu-Gyeong;Bae, Na-Young
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.2
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    • pp.193-204
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    • 2016
  • Objectives This case study is about a Taeeumin patient with advanced Parkinson's disease identified as Dry-heat (Joyeol) pattern. In this study, we report significant improvement of non-motor and motor symptoms after treatment with Cheongsimyeonja-tang.Methods The patient was identified as Taeeumin Dry-heat (Joyeol) pattern and treated with Cheongsimyeonja-tang and acupuncture. The Unified Parkinson Disease Rating Scale (UPDRS) was used to assess the overall functions of the patient. And the global assessment scale (GAS) was used to assess the improvements of dizziness, bradykinesia and tremor after the treatment.Result and Conclusion The UPDRS total score decreased from 138 points to 86 points after 5 weeks treatment. And symptoms of dizziness caused by hypotension, bradykinesia, and tremor showed significant improvement in GAS after the treatment. Furthermore, sleep disturbance and constipation were reported to be improved after the treatment. In conclusion, this study shows that Sasang constitutional medicine can be effective treatment for Taeeumin patient with advanced Parkinson's disease having orthostatic hypotension.

One case treated Tremor(mouth, chin and hand) (수(手), 구순(口脣), 신 진전증(振顫症) 환자(患者)의 치험(治驗) 1례(例))

  • Seong, Gang-Gyeong;Lee, Sang-Gwan;Lee, So-Young;Cheong, Sang-Su;Cheon, Young-Sae;Lee, Si-Woo;Kim, Yo-Han
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.477-482
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    • 2001
  • Tremor refers to rhythmic shaking of a body part. Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. Tremors may be classified as postural, rest or action tremors. Symptomatic treatment is tailored to the tremor type. Because Dansambohyul-tang has been used to treat patients differentiated with an insufficiency of the heart and the spleen(心脾兩虛) in oriental medicine, we treated a 78 year-old female patient who suffered from tremor in mouth, chin and hand and insomnia, with improvement of general condition, who was differentiated with an insufficiency of the heart and the spleen(心脾兩虛) with Dansambohyul-tang, herb complex. After 78 days of treatment with Dansambohyul-tang and some other herb complex, we observed improvement of tremor, insomnia and general condition So Dansambohyul-tang shows therapeutic effects on tremor.

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Prognosis of patients with postural tachycardia syndrome: a follow-up study

  • Kang, Sa-Yoon;Kim, Hong Jun;Ko, Keun Hyuk
    • Annals of Clinical Neurophysiology
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    • v.21 no.1
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    • pp.30-35
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    • 2019
  • Background: Postural tachycardia syndrome (POTS) refers to the presence of orthostatic intolerance symptoms associated with a heart rate increment of greater than 30 beats/min, usually up to 120 beats/min, on head-up tilt test. Symptoms related to POTS are usually light-headedness, palpitations and tremor, but syncope can also occur. The pathophysiology of POTS is heterogeneous and its prognosis is uncertain. Methods: We prospectively evaluated patients who met the criteria for POTS, at baseline and follow-up, using composite autonomic symptom scores and autonomic tests to assess the autonomic function. We compared the clinical and autonomic test results between baseline and follow-up. Results: Sixty-eight patients met the inclusion criteria for POTS and forty-five patients were ultimately followed up for at least 1 year after baseline. The patients were predominantly young females (84%), with a mean age of 21 years. Most patients showed improved orthostatic symptoms and more than a quarter of patients had no longer met the criteria for POTS at follow-up. Conclusions: Most patients had a benign outcome in that they could resume their daily activities without great limitations. Our results demonstrated a relatively favorable prognosis in most patients with POTS.

Study of 4 Cases with Changes of Unified Parkinson's Disease Rating Scale, Heart Rate Variability and Quality of Life in Parkinson's Disease Patients through Whole Body Gi-Hyeol Therapy (전신기혈요법 치료를 통해 Unified Parkinson's Disease Rating Scale, Heart Rate Variability 및 삶의 질이 변화된 파킨슨 환자 4례에 대한 증례보고)

  • Mok, Seo-Hee;Lee, Ji-Won;Lee, Tae-Jong;Seo, Jung-Bok;Kim, Kyoung-Ah;Kim, Joe-Young;Park, Byung-Jun;Kim, Dong-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.2
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    • pp.71-80
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    • 2021
  • Parkinson's disease is one of the typical neurodegenerative disease and it is caused by the destruction of substantia nigra in brain leading to lack of dopamine secretion, and it presents 4 major motor symptoms such as tremor, bradykinesia, stiffness, postural instability. Furthermore, it causes many non-motor symptoms such as anosmia, REM sleep conduct disorder, orthostatic hypotension, dementia and autonomic ataxia such as lack of adjusting blood pressure, hyperhydrosis, constipation. Dopaminergic therapy is the most commonly used strategy, but long term treatment of levodopa induce various adverse effects. Thus, many people are focusing on new therapies other than established therapies, and there are many tries and approaches with paradigm shift. Our medical team was able to get 4 cases of PD patients who are hospitalized in our hospital, treated by Whole Body Gi-Hyeol Therapy consisting of acupuncture therapy, herbal therapy, and mental therapy, and their conditions improved in perspective of Unified Parkinson's Disease Rating Scale(UPDRS), Heart Rate Variability(HRV), and Quality of life. Among all 4 cases, UPDRS score and quality of life score is gotton better, and among 2 cases SDNN, RMS-SD, TP, LF, HF scores are finely increased. And PDQ-39 score which shows quality of life is also improved. However, in spite of these improvements and positive results, there were no meaningful improvement in a hurt from a fall which is important to the aged, muscular atrophy which causes bone fracture and SMI(Skeletal Muscle Mass Index) which is indicator of osteoporosis. Thus, supplementary treatment about Whole Body Gi-Hyeol Therapy such as more active nutrition intervention, safe and effective kinesitherapy is needed, and from now on continuous case reports and systematic clinical research which has control group must be carried out.