Hands shake for a reason: why tremors occur and what to do

What is tremor? It is hyperkinesis, which can manifest itself in the form of involuntary oscillatory rhythmic movements of the limbs, and, in addition, of the head or the whole body. This happens as a result of regular repetition of contractions, as well as muscle relaxation. This pathology is one of the most common disorders of the extrapyramidal type. Often, tremor can be familial in nature, and in some situations it can be completely substandard, having an extremely severe course.

What is tremor?

Tremor is an involuntary rhythmic contraction of the muscles of the human torso, as well as the limbs. Literally translated, the term itself means “trembling.” Such a process can occur during rest, and, in addition, during voluntary movements. Hand tremors in adults contribute to more rough work.

Most often, it happens that actions that involve fine motor skills turn out to be difficult. For example, it is often difficult to thread a needle through the eye. A person’s handwriting can also deteriorate significantly. Factors such as hypothermia, fatigue, increased concentration, along with excessive muscle tension, as a rule, only increase trembling. Often the described pathology affects the upper extremities. This occurs much less frequently in the proximal parts of the body.

Various nature of deviation

Tremors are classified:

by the part of the body in which it occurs (arms, lower extremities, body, head, tongue, voice);
by the nature of origin (with a relaxed or tense state of muscles; in motion or at rest);
physiological - in healthy individuals and pathological (as a symptom of a disease).

Mechanisms of tremor occurrence:

mechanical occurs due to uneven muscle tension, which often depends on the mass of the limb, muscle tone, and the condition of the joints;
reflex occurs as a reaction to changes in the environment, the nerve impulse switches to the motor nerve, and the hand involuntarily makes a movement.
tremor associated with pathological changes in the brain ;
a disorder associated with damage to neural connections in the central nervous system , manifests itself when performing voluntary, purposeful movements.

Based on the nature of their origin, tremor is divided into 3 types:

statistical or resting tremor manifests itself in a relaxed state, is characteristic of those suffering from Parkinson’s disease, and is not always pathological in nature;
postural appears when intensively maintaining a certain posture, for example, clenching your palms into a fist;
intention tremor - occurs during the execution of small movements that require precision (with Wilson-Konovalov disease, multiple sclerosis, tumors).

Based on the vibration frequency, tremor is conventionally divided into 3 groups:

high frequency (9-12 Hz);
mid-frequency (5-8 Hz);
low frequency (3-5 Hz).

Causes of tremor

The structure of the nervous system, which is responsible for the development of such a phenomenon as tremor, has not been sufficiently studied. Pathological forms of tremor are postural, intentional, static and mixed.

The static type of tremor is observed in the presence of the following factors:

Development of parkinsonism.
Presence of essential tremor.
Hepatocerebral dystrophy.
Mercury poisoning.

These are the main causes of tremors in adults.

Postural form is observed with the following deviations:

Lithium poisoning.
Alcohol poisoning of the body.
Presence of thyrotoxicosis
Development of parkinsonism.

There may be other causes of tremor. It can often be observed in states of fatigue, as well as in the presence of feelings of anxiety. The intentional nature of tremor occurs when the cerebellum and, in addition, its connections are damaged.

Etiology

Primary (essential tremor)
Secondary - is a manifestation of the underlying disease (thyrotoxicosis, hyperparathyroidism, liver or kidney failure, brain tumor, traumatic brain injury, stroke, etc.), intoxication or side effects of drugs;
Tremor in degenerative diseases of the central nervous system of a hereditary or idiopathic nature (hepatolenticular degeneration, Parkinson's disease, cerebellar degenerations, idiopathic muscular dystonia);
dull tremor.

Tremor classification

Tremors are classified in terms of oscillatory movements. Thus, a distinction is made between the slow and rapid nature of this disease. Depending on the location of the disease in the human body, tremors of the hands, head, feet and tongue are distinguished. And depending on the factors and conditions of occurrence, the following forms of tremor are distinguished:

Static type, occurring in that part of the body that is at rest.
Intentional or, in other words, dynamic tremor, which manifests itself in the presence of muscle activity.
Postural view. This type of tremor is formed as part of maintaining a position, as well as maintaining the same posture.
The mixed appearance develops at rest or during movement.

Depending on the causes, head tremor can be hysterical, senile, emotional, mercury and alcoholic. It can also appear with thyrotoxicosis and any lesions of the cerebellum. In addition, there are parkinsonian and essential types.

Manifestations of nervousness and trembling sensations

Each person can feel the manifestations of nervousness differently, so it makes no sense to list the numerous variations of this painful feeling. Increased nervousness is considered a symptom of a disorder of higher nervous activity.

Yeast manifestations also have many different variations. More often it manifests itself in the form of internal yeast in the chest, “fluttering”, internal vibration, “buzzing” inside. Less commonly, these symptoms may appear more locally, for example, a person may feel a trembling in the hand or tremors in the leg. At the same time, it is not uncommon to observe muscle twitching in this area of the body.

The feeling of nervousness and/or internal tremors is familiar to almost every adult. These sensations are observed in healthy people during periods of stress or threat of danger. Feelings of tension and anxiety in ordinary people are always accompanied by nervousness, a feeling of internal trembling, sometimes trembling of fingers, arms, and legs.

The main causes of manifestations of nervousness and yeast are the presence of formed mental disorders (most often - borderline mental states, post-stress disorders, anxiety states), the presence of organic or toxic lesions of the nervous system (more often with the manifestation of various complications of alcoholism, with the manifestation of withdrawal syndrome after drinking alcohol, drugs , drug addiction, etc.). Depending on the causes, the treatment of nervousness and yeast is wiped off according to individual principles.

The therapist referred her to a psychiatrist or psychotherapist for consultation. She came in wondering why she needed a psychiatrist. The examination revealed the presence of anxiety-depressive syndrome, complicated by autonomic dysfunction. The treatment was carried out using complex methods: neurometabolic therapy, psychotherapy, a diet was prescribed, and an optimal daily regimen was selected.

Symptoms of the disease

What is tremor and how does it manifest itself? The physiological version of this disease is a rapid and mild tremor of the fingers, eyelids, and head, which occurs in the presence of muscle activity. It can also be associated with tension, coldness, overwork or emotional excitement.

Senile tremor is a mixed trembling of the fingers, and, in addition, of the lower jaw and head, which does not have a significant effect on certain human movements. The dosage form of tremor is usually caused by the following drugs:

Inhibitors in the form of aminophylline and caffeine.
Glucocorticosteroid drugs.
Various adrenergic receptor agonists.
Lithium preparations along with antipsychotics.
Tricyclic antidepressants.
All kinds of psychostimulants, as well as amiodarone.

The mercury form of tremor in adults is observed during poisoning with the substance of the same name. The condition of mercury poisoning can intensify when trying to make voluntary muscle movements. Initially, the mercury type of tremor occurs in the muscles of the face, and then in the limbs.

The alcoholic form of tremor occurs in the form of trembling of the fingers when the arms are extended and spread apart. In addition, the muscles of the tongue and face also suffer. Alcohol tremor occurs when intoxicated with the substance of the same name. This phenomenon can often be observed in patients with alcoholism, as well as in the presence of withdrawal syndrome.

The hysterical nature of the tremor is observed during nervous breakdowns. During hysterics, the tremor has an unstable amplitude and rhythm, having a regular paroxysmal character. This form of tremor is significantly aggravated under the influence of various psychological factors.

When the cerebellum is damaged, it is considered intentional. What are the symptoms of this form of tremor? This type of disease manifests itself in the form of rhythmic oscillations of the limbs as they approach the target. For example, this can happen when you touch the tip of your nose with your finger. Tremor may be of a postural nature, occurring when maintaining certain postures, as well as holding heavy objects.

The essential nature of tremor occurs when performing various actions. It can also occur when maintaining the same position along with maintaining the posture. The tremor is bilateral, but can be asymmetrical. In addition to the limbs, the head may also be involved, along with the lower jaw, legs and vocal cords, among others. Intellectual abilities are preserved. In half of the situations, the essential type of tremor is a hereditary pathology with an autosomal dominant type of transmission of genetic data. True, there is an opinion about the likelihood of damage to the efferent channels of the cerebellum.

Treatment of tremor of the hands and head should be comprehensive.

Intention tremor (shaking): symptoms and treatment of diseases

Tremor is a shaking of a particular part of the body.
This condition is based on muscle contraction and relaxation, which alternates with each other. Trembling limbs can occur at any age, but most often occurs in older patients. In this case, a certain pattern is observed - the older the patient, the faster the disease progresses and the stronger the tremors become.

Tremor can be observed in humans and is normal. However, it is practically invisible to others, unlike pathological trembling.

Thus, tremor can be divided into pathological and physiological.

Other classification approaches for tremor include the following:

By the speed and rhythm of muscle contractions . Fast jitter occurs with a frequency of 6 to 12 Hertz. With slow tremor, oscillations occur with a frequency of 3 to 5 Hertz.
According to localization in a particular muscle group , there may be tremor of the facial muscles, tremor of the limbs, etc.
By severity . Mild tremors do not disrupt a person’s usual way of life; with moderate tremors, there is some limitation in self-care, and with severe tremors, the person cannot do without outside help.

It is also very important for doctors to distinguish between active and passive tremor. Active occurs at the moment when the muscle is in a contracted state.

Passive trembling is said to occur if the contraction and relaxation of a muscle occurs against the background of its complete rest. Intention tremor can be either passive or active.

A peculiarity of tremor is its occurrence at the moment of purposeful movement of the hand towards one or another

subject. It is usually a sign of damage to the cerebellum or nerve pathways connected to it.

This situation occurs in multiple sclerosis.

Other causes of integional tremor may include:

alcoholism;
stroke in the cerebellum or transient circulatory disorders in this part of the brain;
poisoning of the body with various toxic substances, including drugs.

An interesting fact about the effect of alcohol on the severity of tremor.

In the initial period of alcohol consumption, tremors become less pronounced, and patients begin to gravitate towards alcohol. Over time, this leads to increased tremors and the development of alcohol dependence.

Against this background, rapid progression of the disease is observed.

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Over time, intention tremor can lead to the development of a number of complications.

The most common ones are:

Impaired adaptation in society associated with complexes about one’s own inferiority.
Inability to perform certain work , which imposes restrictions on professional activities. For example, patients suffering from tremors cannot be jewelers or surgeons.
Speech disorders due to difficulties associated with damage to the facial and tongue muscles.
Problem in the psycho-emotional sphere associated with impaired ability to perform habitual actions, for example, shaving, brushing teeth, combing one's hair, eating with a spoon or fork, etc.

Clinical signs of intention tremor are:

the appearance of tremors at rest;
increased trembling is observed against the background of any activity (for example, moving a hand towards an object);
the appearance of trembling when wanting to maintain one or another body position;
movements of the limbs are rough and wide;
in comparison with essential tremor, movements are slower;
trembling of only the torso may be observed, while the head and/or limbs do not tremble;
In some patients, the tremor may intensify in a vertical position of the body, and stop when taking a horizontal position.

Special research methods help clarify the diagnosis. They are aimed at identifying the cause of this pathological condition.

Therefore, the doctor recommends the following diagnostic tests:

electroencephalography;
computed tomography of the brain;
study of thyroid hormone levels (increased levels are often observed with essential tremor);
determination of the level of serotonin in the blood, which changes in Parkinson's disease.

During the diagnostic process, the doctor also finds out whether the immediate family has any disorders.

Intentional trembling may have a genetic nature, at the basis of its development. Therefore, in such patients it is necessary to determine whether they have a burdened heredity.

If intention tremor does not cause discomfort to a person and no pathology has been identified in the cerebellum, then treatment may not be necessary.

Some patients require symptomatic therapy to reduce the severity of tremors.

It is impossible to completely get rid of this unpleasant symptom with conservative therapy. To improve the patient's quality of life, drugs from the group of beta blockers are prescribed.

Surgical treatment is indicated when a tumor or cyst is diagnosed in the cerebellum, interfering with its functioning. In this case, no shaking is observed after the operation.

The following conclusions can be drawn:

intention tremor is a sign of damage to the cerebellum by one or another pathological process;
trembling begins at rest, and intensifies when moving the hand towards a particular goal;
sweeping movements that are clearly visible;
a diagnostic search must necessarily exclude a tumor formation localized in the cerebellum;
Conservative treatment is prescribed only by a doctor and uses beta blockers for this purpose; surgery is performed only for tumors.

Tremor and its diagnosis

As a rule, in the presence of tremor, doctors carry out a series of instrumental diagnostic measures that allow them to determine the causes of the corresponding symptoms. Among the examination methods for the presence of tremor, the following diagnostic options are most often used:

The method is called “Rapid”. As part of this technique, certain filming is performed. In this case, a high frequency of the shooting process is carried out with further projection of the captured frames in slow motion.
Tremography procedure. In this method, doctors record tremors in three planes.
Dark photography. With this diagnostic method, luminous elements are fixed on certain segments of the limbs that were involved in the tremor. In the darkness of the vibrations, the luminous elements are photographed on film.
Within the framework of electromyography, a study of muscles is carried out, giving an idea of the nature of rhythmic hyperkinesis.

Any other methods related to the study of tremor are used at the discretion of the attending physician, which also directly depends on the patient’s health status, and, in addition, on the severity of certain pathological signs.

Psychotherapy

Psychotherapy can help cope with body tremors that occur due to stress, anxiety or nervous tension. A specialist, working with a patient, helps him to evaluate differently the events occurring in his life that cause such a reaction in the body.

To get rid of neurosis and depression, rational psychotherapy, cognitive-behavioral, family and other types are used, depending on the problems and personal characteristics of the patient.

The psychotherapist can also suggest and teach the patient the most effective methods of relaxation and “mirroring” negative emotions. For this purpose, breathing exercises, yoga, meditation and other methods are used.

This is more of a symptom than a disease. What do tics, hiccups and involuntary body shudders have in common when falling asleep?

In fact, these phenomena are related by a common nature - malfunctions in the functioning of the system that is responsible for the muscular system. Involuntary movements are not always meaningless than in cases of tics. For example, sharply withdrawing your hand from a hot iron is an uncontrollable useful reaction. It occurs due to nerve cells - motor neurons. With this unconditioned reflex we can avoid getting burned.

What causes uncontrollable nervous trembling or noticeable motor activity in the knees?

The cerebral cortex is responsible for various meaningful motor activities. The urge to action arises right here, it enters the spinal cord along nerve fibers, and from there impulses are sent to the muscles. Thanks to the cerebellum, we can, without thinking, coordinate movements and maintain a normal center of gravity of the body.

And the subcortical nuclei are responsible for the smoothness of movements, rhythm and muscle tone in the brain. With their help, we can perform many different actions, for example, dance movements, jumping, running, nervous trembling. A variety of emotional reactions (facial expressions, laughter, crying) is also the activity of the subcortical nuclei.

Disturbances in the functioning of the system are manifested by the occurrence of all these involuntary movements. In medicine, such excessive activity has its own term - hyperkinesis. This condition is characterized by a weakening of muscle tone along with muscle spasms and violent, meaningless movements.

Nervous tremors: symptoms

If you stretch your arms forward under certain conditions, you may notice that they tremble slightly and a nervous tremor appears. We must also remember about nervous tremors that occur during stress, excitement, anxiety and fatigue. This is a tremor. A similar reaction (nervous tremors) is quite normal for many healthy people.

But you can also encounter tremor (nervous tremors), which is caused by cerebellar lesions. It is characterized by trembling in the leg or arm when approaching the intended target. It happens that trembling begins when holding a heavy object or while maintaining a certain posture. For example, strong trembling of the body and head appears in a standing position and immediately disappears if you lie down.

Another involuntary motor activity that is familiar to many of us is myoclonus (nervous tremors). It involves an immediate contraction of a group of muscles or one muscle at once. Normal hiccups or shuddering when falling asleep are also manifestations of myoclonus. It must be said that hiccups appear when the diaphragm muscles contract involuntarily.

However, a tic (nervous tremor) is the most striking representative of an uncontrolled activity; it is a sharp, short and repeated trembling of the body, head, face, muscles, legs or arms. A simple tic, similar to involuntary blinking, usually appears in early childhood and is usually perceived by others as mannerisms and nervousness.

During adolescence, it usually goes away on its own. But sometimes it happens that movement disorders get worse with age. This happens with Tourette's syndrome, the tic becomes an imitator of more complex movements and begins to be accompanied by the pronunciation of the same type of words and sounds. The vocal tic may even manifest itself as grunting or barking sounds. Uncontrolled foul language often occurs.

Chorea (nervous tremors) - chaotic rapid movements. Often they imperceptibly flow into a person’s meaningful actions. Huntington's chorea, which is hereditary, usually manifests itself with involuntary grimaces, a comical dancing gait, and jerking movements of the legs and arms. Sometimes, a person loses the ability to maintain any position, for example, sitting with his knees together. Chorea of pregnancy may also occur, which develops mainly in the first half of pregnancy.

With athetosis (nervous tremors), ventral-shaped movements of the feet and hands appear with changes in posture. Hemiballismus is characterized by involuntary rotational or throwing lunges with one hand or, in rare cases, with the foot. All this may be accompanied by oral movements.

There are disorders of muscle tone in which a person can take some unnatural posture that greatly interferes with dystonia - normal motor activity. These muscle dystonias spread throughout the entire body or can be concentrated in specific muscle groups. For example, torsion dystonia is manifested by corkscrew-like, slow movements of the body.

While spastic torticollis (nervous tremors) may be accompanied by turning or tilting the head to the side. With blepharospasm, there are grimaces associated with the movement of the lower jaw and obsessive blinking. And I must say about professional dystonias, they appear on the basis of some monotonous work movements.

Toxic poisoning of the brain of the head (for example, copper compounds or alcohol);

Neurotic disorders;

Taking certain medications that are used in psychiatric and neurological practice;

Congenital pathology or hereditary predisposition;

Use of certain drugs;

Head injuries, including birth injuries;

Cerebral circulatory disorders (cerebral hemorrhages and their consequences, arterial blockage, atherosclerosis);

Brain tumors.

Nervous tremors: treatment

To get rid of obsessive unpleasant movements (nervous tremors), it is necessary to determine their real cause, the treatment of which should be directed.

It is often impossible to do without long-term medications that affect the activity of the system that controls the muscle apparatus. But, alas, these medications have many side effects: decreased blood pressure, allergic reactions, stiffness and cause drowsiness. This undoubtedly slows down the healing process. In difficult cases, it is possible to turn to neurosurgical treatment methods.

Basic treatment techniques

If the tremor manifests itself in a mild form, then the process of its treatment can be reduced to the appointment of a relaxing technique. It is extremely important to learn how to avoid all kinds of stress, and, in addition, relieve tension through breathing exercises and other techniques recommended by your doctor. Relaxing baths using soothing essential oils and various herbs can be a great help. It is possible that the patient may be prescribed to take certain sedatives of synthetic or natural origin. If the head tremor is not of a malignant nature and occurs in a mild form, then the above-mentioned procedures are usually quite sufficient to completely eliminate painful symptoms, as well as to relieve nervous tension.

As for cases of the development of severe tremor, which prevents patients from living and working normally, in this situation it is advisable to use potent medications that help eliminate this problem. Most often, these medications are beta-blockers. In relatively low dosages they can reduce the amplitude of tremors. Such medications significantly improve the pathological condition of patients and quickly eliminate the clinical manifestations of the disease process. The causes and treatment of tremor are often interrelated.

As part of the treatment of the essential form of tremor, adrenergic receptor antagonists and drugs such as Clonazepam and Primidone are used. The effects of these medications can be highly addictive, for this reason it is recommended to use them only when absolutely necessary.

Drug treatment of cerebellar tremor, as practice shows, today, unfortunately, is ineffective. Surgical techniques in the form of stereotactic thalamotomy and microstimulation of the thalamus are effective in treating severe forms of this type of tremor. These are the latest treatment methods, which are now successfully used in European countries, as well as in Israel and the USA. As part of deep penetration, electrodes are implanted into the patient's brain area, which stimulate or suppress the activity of certain areas that are responsible for the coordination of movements and directly for the tremor itself. This method is currently being constantly improved. This technique is actively used in the treatment of diseases such as Parkinson’s, epilepsy and others.

Diagnosis and therapy

Making an accurate diagnosis of hand tremors is not easy; this requires a comprehensive study, which may consist of tests, samples, blood tests, fundus examination, blood pressure measurements, thermography, filming, and MRI.

Physiological tremor can occur in any person and be almost unnoticeable to others. Mild and physiological forms usually do not require treatment.

To overcome an unpleasant state, it is enough to know how to relieve stress and drink soothing herbs: lemon balm, chamomile, mint, motherwort, etc.

Treatment of pathological forms of hand tremor is aimed at reducing the intensity of trembling. In the first stages, medications are not prescribed in most cases.

Beta blockers: Propranolol, Obzidan and Anaprilin will help reduce the amplitude of hand tremors in later stages of the disease. If the result is not achieved, then Primidon, Hexamidine, and other anticonvulsants are prescribed.

What to do if the listed drugs do not help and your hands are still shaking - in especially difficult cases, botulinum toxin-A injections are prescribed intramuscularly.

In especially severe cases, when resistant and pharmacological treatment does not help, neurosurgical intervention is used.

Exercises for limbs

Exercises to reduce hand tremors:

Place your palms together and raise them to eye level - this is the starting position. Take a deep breath. As you exhale, lower one hand half a finger, and squeeze the lowered one with the other hand. While inhaling, return to the starting position. Repeat the cycle 10 times.
For hysterical or psychogenic tremors, rubbing the palms until the hands become warm helps.
Strengthen the hands and restore lost control over the muscles of the hands by modeling clay or plasticine, playing musical instruments, and needlework (knitting).
Card tricks develop coordination of movement and concentration.

ethnoscience

Folk remedies for treating hand tremors

If tremors occur due to nervousness, the following are recommended:

in the evening, 150 grams of unpeeled oats are boiled in 2 liters of water, the broth is infused at night, in the morning the mixture is filtered and drunk in small portions throughout the day; course – 5 days, in case of relapse the course is repeated.
soothing teas from heather, valerian, motherwort, mint, lemon balm: 1 tablespoon per 200 ml of water; The decoction is infused and drunk in small portions throughout the day.
A warm bath with 2 liters of broth and a few drops of essential oil will calm the nervous system and help you relax.
meditation and relaxation.

It is often difficult to determine a clinical diagnosis for hand tremors, this is explained by:

a variety of somatic and neurological diseases, the symptom of which is trembling;

patterned manifestation of tremor for various causes and mechanisms of occurrence.

You should:

avoid stressful situations, overwork;
stop using caffeine, tobacco, alcohol;
exercise;
spend active recreation in nature.

How else can you cure the disease?

Treatment of hand tremors directly depends on the causes.

To get rid of essential tremors, doctors practice prescribing the following medical substances:

Benzodiazepines.
Beta-adrenergic antagonists
The drug "Primidon".

At the same time, adrenergic blockers are considered most effective, whose action is aimed at a general reduction in the amplitude of oscillations. Small doses of benzodiazepines can also reduce the severity of familial tremor. They can be used as monotherapy, as well as in combination with adrenergic blockers. Doctors recommend taking these drugs in courses, since over time a lack of sensitivity to them may develop.

Medicinal methods of influencing cerebellar tremor are very often ineffective. An effective approach to treating severe cerebellar tremor is microstimulation of the thalamus or stereotactic thalamotomy.

Propranolol is effective in the treatment of alcohol tremors that occur after a hangover. For young patients, medications from the beta blocker category are often prescribed as an adjunct, as they are effective in the presence of high blood pressure. For elderly patients whose alcohol addiction has reached an advanced stage, it is recommended to prescribe Primidon, since this drug does not have any side effects on the functioning of blood vessels and the heart.

Treatment for shaking, which is caused by Parkinson's disease, involves taking medications that are similar to dopamine. For example, these are medications such as Pergolide and Ropinirole. They should be used with extreme caution, as they can cause manifestations in the form of tardive dyskinesia, clonus and psychosis. In addition, it is recommended to prescribe medications to reduce the severity of parkinsonian tremor. For these purposes, as a rule, anticholinergic drugs such as Benzatropine and Amantadine are used. Patients with rubral twitching may find relief from the use of anticholinergic medications, as well as levadopa.

Among other things, patients who are interested in how to get rid of tremors can always use the secrets and techniques of traditional medicine. True, it is recommended to begin any independent treatment in order to get rid of painful symptoms under the strict supervision of a specialist.

Excerpt characterizing Tremor

“The adjutant of Prince Kutuzov brought me a letter in which he demands from me police officers to accompany the army to the Ryazan road. He says that he is leaving Moscow with regret. Sovereign! Kutuzov’s act decides the lot of the capital and your empire. Russia will shudder upon learning of the cession of the city where the greatness of Russia is concentrated, where the ashes of your ancestors are. I will follow the army. I took everything away, I can only cry about the fate of my fatherland.” Having received this report, the sovereign sent with Prince Volkonsky the following rescript to Kutuzov: “Prince Mikhail Ilarionovich! Since August 29 I have not had any reports from you. Meanwhile, on September 1st, through Yaroslavl, from the Moscow commander-in-chief, I received the sad news that you had decided to leave Moscow with the army. You yourself can imagine the effect this news had on me, and your silence aggravates my surprise. I am sending with this general the adjutant Prince Volkonsky in order to find out from you about the position of the army and the reasons that prompted you to such sad determination.” Nine days after leaving Moscow, a messenger from Kutuzov arrived in St. Petersburg with official news of the abandonment of Moscow. This sent was the Frenchman Michaud, who did not know Russian, but quoique etranger, Busse de c?ur et d'ame, [however, although a foreigner, he was Russian at heart,] as he himself said to himself. The Emperor immediately received the messenger in his office, in the palace of Kamenny Island. Michaud, who had never seen Moscow before the campaign and who did not speak Russian, still felt moved when he appeared before notre tres gracieux souverain [our most gracious sovereign] (as he wrote) with the news of the fire of Moscow, dont les flammes eclairaient sa route [whose flame illuminated his path]. Although the source of Mr. Michaud's chagrin [grief] should have been different from the one from which the grief of the Russian people flowed, Michaud had such a sad face when he was brought into the Tsar's office that the Tsar immediately asked him: - M' apportez vous de tristes nouvelles, colonel? [What news did you bring me? Bad ones, Colonel?] “Bien tristes, sire,” answered Michaud, lowering his eyes with a sigh, “l'abandon de Moscou.” [Very bad, Your Majesty, leaving Moscow.] - Aurait on livre mon ancienne capitale sans se battre? [Have they really betrayed my ancient capital without a battle?] - the sovereign suddenly flushed and said quickly. Michaud respectfully conveyed what he was ordered to convey from Kutuzov - namely, that it was not possible to fight near Moscow and that, since there was only one choice left - to lose the army and Moscow or Moscow alone, the field marshal had to choose the latter. The Emperor listened in silence, without looking at Michaud. – L'ennemi est il en ville? [Has the enemy entered the city?] he asked. – Oui, sire, et elle est en cendres a l'heure qu'il est. Je l'ai laissee toute en flammes, [Yes, your Majesty, and he is turned into a conflagration at the present time. I left him in the flames.] - Michaud said decisively; but, looking at the sovereign, Michaud was horrified by what he had done. The Emperor began to breathe heavily and quickly, his lower lip trembled, and his beautiful blue eyes instantly became wet with tears. But this lasted only one minute. The Emperor suddenly frowned, as if condemning himself for his weakness. And, raising his head, he addressed Michaud in a firm voice. “Je vois, colonel, par tout ce qui nous arrive,” he said, “que la providence exige de grands sacrifices de nous... Je suis pret a me soumettre a toutes ses volontes; mais dites moi, Michaud, comment avez vous laisse l'armee, en voyant ainsi, sans coup ferir abandonner mon ancienne capitale? N'avez vous pas apercu du decouragement?.. [I see, Colonel, from everything that is happening, that Providence requires great sacrifices from us... I am ready to submit to his will; but tell me, Michaud, how did you leave the army that was leaving my ancient capital without a battle? Have you noticed a loss of spirit in her?] Seeing the calmness of his tres gracieux souverain, Michaud also calmed down, but to the sovereign’s direct, essential question, which also required a direct answer, he had not yet had time to prepare an answer. – Sire, me permettrez vous de vous parler franchement en loyal militaire? [Sir, will you allow me to speak frankly, as befits a real warrior?] - he said to gain time. “Colonel, je l'exige toujours,” said the sovereign. – Ne me cachez rien, je veux savoir absolument ce qu'il en est. [Colonel, I always demand this... Don’t hide anything, I definitely want to know the whole truth.] - Sire! - said Michaud with a thin, barely noticeable smile on his lips, having managed to prepare his answer in the form of a light and respectful jeu de mots [play on words]. - Sire! j'ai laisse toute l'armee depuis les chefs jusqu'au dernier soldat, sans exception, dans une crainte epouvantable, effrayante... [Sir! I left the entire army, from the commanders to the last soldier, without exception, in great, desperate fear...] – Comment ca? – the sovereign interrupted, frowning sternly. – Mes Russes se laisseront ils abattre par le malheur... Jamais!.. [How so? Can my Russians lose heart before failure... Never!..] This was just what Michaud was waiting for to insert his play on words. “Sire,” he said with a respectful playfulness of expression, “ils craignent seulement que Votre Majeste par bonte de céur ne se laisse persuader de faire la paix.” “Ils brulent de combattre,” said the representative of the Russian people, “et de prouver a Votre Majeste par le sacrifice de leur vie, combien ils lui sont devoues... [Sir, they are afraid only that your Majesty, out of the kindness of his soul, will not decide to make peace . They are eager to fight again and prove to Your Majesty by the sacrifice of their lives how devoted they are to you...]

Tactics for tremor

Patients often ask what effective treatments are available for tremors of the head, arms or legs. But tremor cannot be treated; its cause (the disease that accompanies it) must be addressed.

Tremor can have different origins. Therefore, if a patient has this pathology, he should contact a therapist, who, after conducting an examination, will give recommendations on which doctor should be contacted next - a neurologist, endocrinologist, infectious disease specialist or other specialized specialists.

Often, to find out the cause of tremor, the patient must undergo many examinations of different organs and systems. Also, in a number of clinical cases, a patient with tremor is treated by several doctors of related specialties (for example, for diabetic neuropathy, treatment will be prescribed jointly by an endocrinologist and a neurologist).

Recommendations on how to treat essential tremor in a child should be given by a highly qualified neonatologist.

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Causes and symptoms of tremor in infants

Signs of tremor can be noticed in almost all children immediately after birth. Most often this is:

twitching of arms and legs;
chin trembling;
twitching of lips.

Basically, symptoms of tremor in infants appear under the following circumstances:

if the fetus had hypoxia;
under circumstances associated with tension - during excitement, during crying, when painful sensations occur;
in premature babies (due to immaturity of the nervous system).

Tremors often go away on their own before the age of 3 months. If it occurs at a later age, you should consult a doctor.

Causes of the disease

Osteochondrosis can develop in any part of the spine. The cause of the disease is chronic degenerative changes, leading to hydrophilicity and destruction of the tissue of the intervertebral discs with their subsequent protrusion towards the intervertebral canal, where there is a cluster of pain receptors. This displacement of the discs injures the spinal cord and disrupts the conduction of nerve impulses. Osteochondrosis is characterized by the appearance of osteophytes - bone formations, which are popularly called salt deposition. Such growths cause compression of blood arteries and nerve roots.

Tremor is not the main manifestation of osteochondrosis, but can periodically appear with such pathology.

In the vast majority of cases, the problem occurs when vessels and nerves are pinched by osteofts in the area of the first vertebra.
Most often (in 90% of cases) it occurs when the first cervical vertebra is pinched. Compression of blood vessels and nerve endings by the resulting osteophytes leads to disruption of the nutrition of the spinal cord and brain, which sometimes causes uncoordination of movements. Physiologically, tremor is explained by the fact that impulses responsible for mobility or immobility enter the nervous system with some delay. This causes involuntary muscle contractions and trembling, similar to the state of a person when he is frozen. The symptom appears suddenly, acts on an unconscious level and is not controlled, and can appear in both a calm and active state.

Who is at risk?

Most often, with osteochondrosis, tremor of the hands or head of varying intensity appears in people over 50 years of age - a typical sign of a spine susceptible to age-related deformation. However, this condition can be observed in very young people with congenital or acquired disease of the spinal column. Common causes that can cause tremor in any person are aggravated by the presence of osteochondrosis. The following factors are provocateurs:

The symptom can be triggered by drinking alcohol in large quantities.

prolonged stress;
hormonal imbalance;
increased blood pressure;
alcohol abuse;
smoking;
long journeys by car;
physical work;
previous spinal surgeries.