Is hand tremor Parkinson's? There's a difference between tremor and Parkinson's!

When many elderly people experience hand tremors, their families often immediately assume, "This is Parkinson's disease." However, hand tremors aren't necessarily caused by Parkinson's; they could be related to other medical conditions.

◆ What is tremor?

Tremor generally has two meanings: one refers to a tremor in behavior; the other is the name of a disease. Tremor is an uncontrolled, rhythmic, rapid, oscillatory movement in one or more parts of the body. It is caused by the synchronized or alternating contractions of the agonist and antagonist muscles that control that part. It can affect the hands, arms, head, face, eyes, vocal cords, trunk, and legs. It most often occurs in the head and hands and is exacerbated by anxiety and stress. There are many types of tremor, but they can generally be categorized as physiological or pathological. However, regardless of the type of tremor, the symptoms are limited to localized, oscillatory movements of the organs.

◆ What is Parkinson's?

Parkinson's disease is a very common degenerative neurological disease in the elderly, characterized by both typical motor and non-motor symptoms.

Parkinson's disease has many typical symptoms. Motor symptoms include resting tremor, muscle rigidity, bradykinesia, and postural and balance disorders; non-motor symptoms include sensory impairment, sleep disturbances, autonomic dysfunction, and mental disorders.

◆ What are the differences between tremor and Parkinson's disease?

01. Different Causes

Tremors are generally caused by a variety of conditions, including neurodegenerative diseases (Parkinson's disease, corticobasal degeneration, multiple system atrophy, progressive supranuclear palsy, etc.), chromosomal abnormalities (such as XYY, XXY, and XXYY syndrome), infectious or other inflammatory diseases (epidemic encephalitis, subacute sclerosing encephalitis, tuberculosis, HIV/AIDS, syphilis, measles, typhoid fever, etc.), endocrine and metabolic diseases (hyperthyroidism, liver and kidney failure), hereditary mitochondrial diseases (mitochondrial polymerase Y mutations, Leigh syndrome, etc.), neuromyelopathy (immunoglobulinemia, Guillain-Barré syndrome, Kennedy syndrome), as well as intracranial injury, intracranial tumors, and vascular myopathies.

Parkinson's disease is associated with the degeneration and death of dopaminergic neurons in the substantia nigra, but the exact cause of this neuronal degeneration and death remains unclear. Experts believe it may be due to a combination of genetic factors, environmental factors, and the aging of the nervous system.

1. Genetic Factors: Studies have found that 10% of Parkinson's patients have a family history.
2. Environmental factors: The environment may contain agricultural toxins or industrial pollution with structures similar to neurotoxin molecules, such as some herbicides, pesticides, and rotenone, which may also contribute to Parkinson's disease.
3. Aging of the nervous system: With aging, dopaminergic neurons in the substantia nigra gradually degenerate, leading to the development of Parkinson's disease.

02. Different treatments

1. Tremor: Essential tremor can be treated with medications such as primidone, alprazolam, propranolol, sotalol, and gabapentin to improve symptoms. For dystonic tremor and focal essential tremor that are ineffective with oral treatment, local injection of botulinum toxin type A can be used.
2. Parkinson's disease: In the early stages, treatment is often with a single drug or a combination of low-dose, targeted drugs to stabilize symptoms and prolong the drug's effectiveness. These drugs include anticholinergics, amantadine, dopamine receptor agonists, levodopa, catechol-O-methyltransferase inhibitors, and monoamine oxidase type B inhibitors.

In the mid-to-late stages of the disease, if motor complications occur, exercise rehabilitation is prioritized to alleviate postural and balance disorders. For non-motor symptoms, symptomatic treatment is used. Restless legs syndrome can be treated with a DR agonist or levodopa within two hours of bedtime.

Frequent hallucinations and delusions can be treated with medications such as olanzapine, ammonia, and valproate. For patients whose symptoms are inadequately alleviated by medication, surgery is an alternative. Commonly used methods include nucleus ablation and deep brain stimulation. Surgery can significantly improve motor symptoms and simultaneously alleviate limb tremors, significantly improving quality of life. In short, tremors and Parkinson's disease are not the same.

Parkinson's disease may cause tremors in patients, but tremors are not necessarily caused by Parkinson's disease. If you or your family members experience tremors, you should go to the hospital for systematic diagnosis and treatment in a timely manner.