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Essential Tremor in Older adults As we age, we face a host of age related changes, like hearing impairments, visual changes, increased short-term memory loss, natural bone loss, and decreased mobility. Comorbidities also increase with age such, as arthritis, hypertension, and heart disease. Another prevalent and often disregarding age related occurrence are essential tremors (ET) also referred to as senile tremors, familial tremors, benign tremors, intentional and action tremor. Essential tremors are the most common place neurological disorder in older adults (Louis & Ferreira 2010). It is defined as involuntary rhythmic movements of any body part. Typically affecting the fingers, hands, and forearm, less commonly they may affect the head and legs. Movememnt can be fast or slow visible with rest, action or sustained posture (Abboud & Ahmed, 2011). Though this is a frequently occurring condition, it often misdiagnosed or underdiagnosed due to lack of admission by patient or clinician inability to recognize signs and symptoms. Prevalence/Epidemiology According to Elias, Binit, and Shah (2014) it is estimated the 10 million to 20 million Americans suffers from ET and 6.3 % of the population is affected worldwide. The average age of onset is 52, but can present at ages greater than 60 and as young as 8 years old. Males are minimally affected more than women and there is no discrimination related to the patients’ race. ETs is a progressive disease that can negatively impact patients’ gross motor skill such as writing, getting dressed, cooking meals, fine motor skills such as writing thus causing distress at home and in the work environment. This disease can have a great impact on the patient mental health resulting from co... ... middle of paper ... ...ne, 311(9), 948-953. Khalil, A., & Malik, S. (2013). Movement disorders and tremors. InnovAiT: The RCGP Journal for Associates in Training, 6(7), 416-424. Louis, E., & Ferreira, J. (2010). How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor. Movement Disorders, 25(5), 534-541. Louis, E. D. (2009). Essential Tremors: A Family of Neurodegenerative Disorders? Archives of Neurology, 66(10), 1202-1208. Pal, P. (2011). Guidelines for management of essential tremor. Annals of Indian Academy of Neurology, 14(5), 25. Preventing Falls Among Older Adults. (2013). Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/Features/OlderAmericans/ Yaman, A., Akdeniz, M., & Yaman, H. (2011). How best to address these common movement disorders. The Journal of Family Practice, 60(12), 721-725.
In recent years researchers have made significant advances in the field and have come up with many neuroleptic (antipsychotic) medications to treat the disorder. However along with these medical breakthroughs problems have occurred. The most severe side effect is called Tardive Dyskinesia, literally meaning "late movement disorder." (1) Coined in 1964, it is identified by the involvement of numerous "abnormal, involuntary movements of the orofacial area or extremities." . (2) More specifically, it is characterized by rocking, twisting, jerking, toe tapping, lip smacking, blinking, and most commonly an unusual movement of the tongue. . (1) (2)(3). Interestingly enough, these side effects disappear during sleep. (3)
The prevention of falls in the long term care facility is one of the most important interventions the health care team can do to ensure the safety of loved ones under their care. According to the Summary Data of Sentinel Events Reviewed by the Joint Commission (2016), there were 806 falls between 2004-2015 with 95 of those occurring in 2015 . As health care providers, we have a responsibility to incorporate interventions that will help protect the patient while under our care. Interventions as simple as ensuring the use of a gait belt by any team member that transfers the patient, to making sure all team members are aware of the medications that can make certain patients more of a fall risk, will help in the prevention of falls.
Goldmann, David R., and David A. Horowitz. American College of Physicians Home Medical Guide to Parkinson's Disease. New York: Dorling Kindersley Pub., 2000. Print.
People who have been diagnosed with this lifelong disease have either started to see the early signs and symptoms or have yet to recognize them. The negative impact that fatigue, loss of muscle strength and in-coordination has on the patients with Parkinson’s disease can be improved with a well-balanced exercise regimen. The three most common physical symptoms the patient will experience are tremors, rigidity, and bradykinesia. “Tremors while at rest are the most common initial symptom and are present in around 70 percent of cases at disease onset. It often presents as a pill rolli...
The four key symptoms of Parkinson’s disease are tremors of the hands, arms, legs, or
Rocha, J. A., Reis, C., Simoes, F., Fonseca, J., & Mendes Ribeiro, J. (2005). Diagnostic investigation and multidisciplinary management in motor neuron disease. Journal of Neurology, 252(12), 1435–1447.
The basal ganglia are part of the extrapyramidal system and work in conjunction with the motor cortex in providing movement and serve as the relay center. Damage to this area results in Athetoid Cerebral Palsy, the second most common form of cerebral palsy. Involuntary purposeless movements, particularly in the arms, hands, and facial muscles, characterize Athetosis. In addition, the individual can become “stuck” in abnormal positions or postures and require specific positioning to maintain more normal tome and
Bradykinesia is a Greek term that means "slow movement", and it is one of the constituents of Parkinson's disease (2), although it is also associated with other diseases. For patients suffering from Parkinson's disease, it is usually the most tiring and frustrating of the associated conditions. Small muscle movement is one of the first affected areas of the body. Therefore, a common test is to ask the patient to tap her finger. Normal individuals tap their fingers at 4 or 5 Hz, someone afflicted with bradykinesia can usually manage only up to 1 Hz.(3) There is no cure for bradykinesia. Certain surgeries may help decrease the condition. Hope remains for the future while researchers continue to explore different possibilities, examining causes and treatments that will lead to a cure and to more clues about Parkinson's disease, Huntington's disease, and other conditions with which bradykinesia is associated. (4)
In the 1960’s, an Austrian pediatrician, Dr. Andres Rett, recognized a few of his female patients with similar indications of having some type of neurologic disorder but did not fit the cerebral palsy classification (Zoghbi, 2002). Without the knowledge of earlier research, a Swedish physician, Bengt Hagberg, began to openly speak about his observations similarly to Dr. Andres Rett records (Zoghbi, 2002). Bengt Hagberg observed numerous of female patients with this unknown syndrome and was curious in their wringing hand movement that no textbook had information on. In June 1981 Dr. Neil Gordon hosted a board meeting of the European Federations of Child Neurology Societies in Manchester and Bengt Hagberg had the opportunity to share his studies there. The discussion group had other pediatric neurologists that had seen the same behaviors but they all were unable to categorize it into its own identity. As years past, this syndrome has increased and neurologist began to evaluate this syndrome t...
Epilepsy, also known as “seizure disorder,” or “seizure attack,” is the fourth most common neurological disorder known to mankind, affecting an estimated 2.3 million adults and 467,711 children in the United States. Unfortunately this disorder is becoming far more common and widespread worldwide. This staggering number of cases of people suffering from Epilepsy also involves an average growth rate of 150,000 new cases each year in the United States alone. Generally, many of the people who develop who are a part of the new are mainly either young children or older adults. Your brain communicates through chemical and electrical signals that are all specialized for specific tasks. However, through the process of communication, chemical messengers, also known as neurotransmitters can suddenly fail, resulting in what is known as a seizure attack. Epilepsy occurs when a few too many brain cells become excited, or activated simultaneously, so that the brain cannot function properly and to it’s highest potential. Epilepsy is characterized when there is an abnormal imbalance in the chemical activity of the brain, leading to a disruption in the electrical activity of the brain. This disruption specifically occurs in the central nervous system (CNS), which is the part of the nervous system that contains the brain and spinal cord. This causes an interruption in communication between presynaptic neurons and postsynaptic neurons; between the axon of one neuron, the message sender and the dendrite of another neuron, the message recipient. Consequently, the effects that epileptic seizures may induce may range anywhere from mild to severe, life-threatening ramifications and complications. There are many different types of seizures associa...
Most signs and symptoms of Parkinson disease correspond to one of three motor deficiencies: bradykinesia, akinesia, tremor, and rigidity. The first two qualities are usually present before tremor, but often attributed to aging by the patient and even the physician, and thus the disease is rarely diagnosed until tremor becomes evident much later. An average of 80% of the nigrostriatal neurons may have already degenerated by the time Parkinsonism is diagnosed, which complicates treatment (Fitzgerald, 130). Bra...
When taking steps to analyze and apply intervention strategies for falls, we must examine the factors that cause these occurrences. There are numerous reasons that falls occur, such as intrinsic and or extrinsic risk factors. Intrinsic risk factors for falls may be due to changes that are part of the normal aging process and acute or chronic conditions. According to Zheng, Pan and Hua et al. (2013), about 35-45 percent of individuals who are usually older than 65 years and other 50 percent of the elderly individuals report cases of fall every year. Extrinsic factors are those related to physical environment such as lack of grab bars, poor condition of floor surfaces, inadequate or improper use of assistive devices (Currie). Patient falls is not an easy thing to eliminate. With many clinical challenges, there’s no easy answer to the challenges posed by patient falls; howe...
Parkinsons disease Learning is defined as, a change in the capability of a person to perform a skill that must be inferred from a relatively permanent improvement in performance as a result of practice of experience (Magill 247). For healthy people to learn a skill, they must show improvement, consistency, stability, persistence, and adaptability. However, for patients with Parkinsons Disease, it is not as simple. Bradykinesia, the slowed ability to initiate and continue movements, is a well-recognized side effect of Parkinsons Disease. In Rostami and Ashayeris study, Effects of motor skill practice on reaction time and learning retention in Parkinsons Disease, they investigated whether or not short-term practice could improve Bradykinesia. Patients with Parkinsons Disease frequently spend more time not only initiating voluntary movements, but also more time carrying out the voluntary movements. Thus, the study gathered 9 patients (7 males and 2 females) with Parkinsons Disease and 9 controls (7 males and 2 females) that were healthy and disease free. The participants were instructed to look at their monitor and to carry out a hand-to-mouth reach when prompted by the random stimulus on the monitor. The researchers used the Kinemetrix 3D Motion Analysis System and three markers that were positioned on the lateral aspect of the wrist, elbow, and shoulder joints to record and analyze the movements in three-dimensional space. Though all of the participants were right-handed, they were all instructed to use their left hand to complete the task because in all of the participants the left arm appeared to be more bradykinetic. The purpose of this study was to see if reaction time coul...
Robert A Hauser, Rajesh Pahwa, Kelly E Lyons, Theresa McClain, 2010. Parkinson Disease. Medscape, Neurology.
70 % of people believe that everyone who trembles has Parkinson. This common confusion for the lack of knowledge affects the lives of many who have the Essential Tremor (ET). The cause, symptom and treatment of ET seem similar to those of Parkinson's but these are in important points completely opposite and it is good to know how to differentiate it.