Ukungcangcazela kunye nokungcangcazela okuyimfuneko

Uphawu lokungcangcazela olubonwa kwi-ET luyi-postural kunye neentshukumo zentshukumo, kunye ne-frequency ye-4-7 Hz. Oku kungcangcazela kusenokuqala ngobuqhetseba kwasebutsheni babo, ngokunyuka kobunzulu benyikima ngokuhamba kweminyaka. Ukukhubazeka kwi-ET kuhambelana nokukhubazeka kwemisebenzi yokuzithandela eyenzeka ngenxa yokuthuthumela. Izigulana zihlala zikhalaza ngokungcangcazela xa zisitya, zisela kwaye zibhala, zichitheka phezu kokutya neziselo kwaye ziphuhlisa ukubhala ngesandla okungafundekiyo. Awona malungu omzimba achaphazeleka kakhulu abandakanya izandla, intloko kunye nelizwi, kodwa angabonwa nasemilenzeni, esiqwini nasebusweni.

Ngaphandle kokuba ikakhulu kukungcangcazela kwe-postural, i-kinetic tremor inokubakho kwaye ngamanye amaxesha ukungcangcazela okuphumlayo okunobunzulu obuncinci kunokuxatyiswa. Ukuthuthumela kwi-ET kugqithiswa yimiqathango njengoxinzelelo, ukuzivocavoca kunye nokukhathala, i-caffeine, amayeza athile kunye nokuphucula ngokuphumla kunye needosi ezincinci zotywala. Izigulane zihlala zinembali yosapho.

Unyango oluqhelekileyo lwe-ET lubandakanya: i-beta blockers njengeproporanolol, i-primidone kunye ne-topiramate. Ngamanye amaxesha, ukungcangcazela kweyeza-refractory, ukuvuselela ingqondo enzulu ye-VIM nucleus yethalamus kuqwalaselwa.

Ixhaswe nguHubert Fernandez, MD
Intloko, iziphazamiso zeMovement
ISebe leNeurology
Kliniki yaseCleveland
Cleveland, Ohio USA

Ihlaziywe ngo-2019: Ixhaswe nguSusan A. Schneider, MD
Umcebisi weNeurologist
Isibhedlele saseYunivesithi iMunchen
Pullach, eJamani

I-etiology yokungcangcazela yahlukile, kwaye ibandakanya ukungcangcazela okuyimfuneko (kunye nama-50% ane-FH eqinisekileyo kodwa akukho mfuza omnye ichongiwe); njengenxalenye yokuphazamiseka kwemfuza umz. isifo sikaWilson; ukuwohloka okufana nesifo sikaParkinson, izifo zeMetabolic (ezifana ne-thyroid-, i-parathyroid-, isifo sesibindi kunye ne-hypoglycemia); i-peripheral neuropathies (umz. eyayanyaniswa neCharcot-Marie-Tooth; eyenzelwe iziyobisi (kubandakanywa i-narcoleptics, i-tricyclics, i-lithium, i-cocaine, i-alcohol, i-adrenaline, i-bronchodilators, i-theophylline, i-caffeine, i-steroids, i-valproate, i-amiodarone, i-thyroid hormones, i-vincristineavy metalfuncristine) kunye ne-vincristineavy metalfuncristine; ukuphazamiseka.

Iikhrayitheriya zokuqala zesivumelwano ezicetywe yi-MDS ukususela ngo-1998 zihlaziywe kutshanje ukuze koyiswe ngcono ukungangqinelani, ngakumbi ngokubhekiselele kwi-essential tremor (ET), i-tremor enxulunyaniswa ne-dystonia okanye ezinye iingxaki ze-neurological, kunye ne-focal tremor. Isivumelwano esitsha sicebisa ukuba udidi luneendlela ezimbini eziphambili: iimpawu zeklinikhi (i-Axis 1) kunye ne-etiology (i-Axis 2).

Ngokweklinikhi, i-syndrome equka ukungcangcazela kuphela ibizwa ngokuba sisifo sokungcangcazela esisodwa. Ngakolunye uhlangothi, i-syndrome equka ukuthuthumela kunye nezinye iimpawu ze-systemic okanye ze-neurological zibizwa ngokuba yi-combined tremor syndrome.

Ngokwe-Etiological, ukungcangcazela kunokwahlulwa kube kukungcangcazela, ukungcangcazela komzimba okuphuculweyo, ukungcangcazela okubalulekileyo (kubandakanya i-classical ET), idystonic tremor, i-parkinsonian tremor, i-cerebellar tremor (ehlala ihambelana nemultiple sclerosis), ukungcangcazela kukaHolmes (aka rubral tremor), ukungcangcazela kwelizwi, ukungcangcazela kweziyobisi, ukungcangcazela kweziyobisi, ukungcangcazela kwengqondo.

Ixhaswe nguLeo Verhagen, MD, PhD
UNjingalwazi oDityaniswayo weNzululwazi yeNzululwazi
IZiko lezoNyango leYunivesithi iRush
EChicago, e-IL, e-USA

Uhlaziyo luka-2019 oluxhaswe ngu:

USusanne A. Schneider, MD
Umcebisi weNeurologist
Isibhedlele seYunivesithi yaseLMU eMuenchen
IMunich, eJamani

USusan Fox, uMRCP (UK), PhD
Unjingalwazi weNeurology
KwiYunivesithi yaseToronto, kwisibhedlele saseToronto saseNtshona
Toronto, ON, Canada