Trembling Health Dictionary

A slowly progressive, fatal disease due to spongiform degeneration in the central nervous system, particularly the cerebellum (see BRAIN). It is con?ned to the Fore people in the Eastern Highlands of New Guinea, and causes increasingly severe muscular trembling. Kuru is believed to be due to an infection with a PRION, similar to that causing CREUTZFELDT-JAKOB DISEASE (CJD), acquired from the cannibalistic rite of eating the organs, particularly the brains, of deceased relatives (out of respect). This origin of the disease was suggested by the fact that originally it was a disease of women and children, and it was they who practised this rite. Since the rite was given up, the disease has largely disappeared.... kuru

A rapidly progressive, fatal, degenerative disease in humans caused by an abnormal PRION protein. There are three aetiological forms of CJD: sporadic, IATROGENIC, and inherited. Sporadic CJD occurs randomly in all countries and has an annual incidence of one per million. Iatrogenic CJD is caused by accidental exposure to human prions through medical and surgical procedures (and cannibalism in the case of the human prion disease known as kuru that occurs in a tribe in New Guinea, where it is called the trembling disease). Inherited or familial CJD accounts for 15 per cent of human prion disease and is caused by a MUTATION in the prion protein gene. In recent years a new variant of CJD has been identi?ed that is caused by BOVINE SPONGIFORM ENCEPHALOPATHY (BSE), called variant CJD. The incubation period for the acquired varieties ranges from four years to 40 years, with an average of 10–15 years. The symptoms of CJD are dementia, seizures, focal signs in the central nervous system, MYOCLONUS, and visual disturbances.

Abnormal prion proteins accumulate in the brain and the spinal cord, damaging neurones (see NEURON(E)) and producing small cavities. Diagnosis can be made by tonsil (see TONSILS) biopsy, although work is under way to develop a diagnostic blood test. Abnormal prion proteins are unusually resistant to inactivation by chemicals, heat, X-RAYS or ULTRAVIOLET RAYS (UVR). They are resistant to cellular degradation and can convert normal prion proteins into abnormal forms. Human prion diseases, along with scrapie in sheep and BSE in cattle, belong to a group of disorders known as transmissible spongiform encephalopathies. Abnormal prion proteins can transfer from one animal species to another, and variant CJD has occurred as a result of consumption of meat from cattle infected with BSE.

From 1995 to 1999, a scienti?c study of tonsils and appendixes removed at operation suggested that the prevalence of prion carriage may be as high as 120 per million. It is not known what percentage of these might go on to develop disease.

One precaution is that, since 2003, all surgical instruments used in brain biopsies have had to be quarantined and disposable instruments are now used in tonsillectomy.

Measures have also been introduced to reduce the risk of transmission of CJD from transfusion of blood products.

In the past, CJD has also been acquired from intramuscular injections of human cadaveric pituitary-derived growth hormone and corneal transplantation.

The most common form of CJD remains the sporadic variety, although the eventual incidence of variant CJD may not be known for many years.... creutzfeldt-jakob disease (cjd)

(Hebrew) A trembling woman... gaash

Guarana tea has been recognized by generations of people from the Amazon as being an energy booster and a strong helper for those with cognitive problems. Guarana is a climbing plant that grows in the Amazon and in the tropical forests of Brazil. Its seeds are mostly used as a caffeine substitute in energy drinks. The constituents of guarana plant are caffeine (guarana tea contains 2.5 times the amount of caffeine than coffee) and traces of theophylline and thebromine (commonly used as stimulants). How To Make Guarana Tea You can make guarana tea by boiling 2 grams of crushed guarana seeds in 250 ml of water. Let it boil for about 10 minutes then wait for it to cool down a little bit. Then, by using a trainer to catch the guarana seeds, pour the tea into your cup. Optionally, sweeten it with sugar or honey. Guarana Tea Benefits

• Guarana tea may be effective in treating headaches, but only as a short-term treatment, according to the University of Colorado Denver College of Pharmacy.
• Enhances memory, alertness and other cognitive capacities.
• Boosts energy and alleviates depression.
• Treats chronic diarrhea.

Guarana Tea Side Effects The side effects of guarana tea are associated with over consumption. If you drink too much guarana tea you may experience the same side effects that you can have when drinking too much coffee, such as:

• Anxiety
• Trembling
• Hyperactivity
• Frequent urination
• Palpitation

Needless to say, pregnant and breastfeeding woman should not drink guarana tea! All in all, do not drink more than 3 cups of guarana tea per day! This way your body gets the exact amount of caffeine that it needs and you can be sure you would not experience its side effects!... guarana tea

(Hebrew) Born during the earth’s trembling

Marala, Marallah, Maralla... maralah

(English) Of the trembling aspen Waverley, Waverlie, Waverli, Waverlee, Waverleigh, Waverlea, Waverleah... waverly

Paired nerve cell clusters deep within the cerebrum (the main mass of the brain) and upper part of the brainstem.

The basal ganglia play a vital part in producing smooth, continuous muscular actions and in stopping and starting movement.

Any disease or degeneration affecting the basal ganglia and their connections may lead to the appearance of involuntary movements, trembling, and weakness, as occur in Parkinson’s disease.... basal ganglia

A state of confusion accompanied by trembling and vivid hallucinations.

It usually arises in alcoholics after withdrawal or abstinence from alcohol.

Early symptoms include restlessness, agitation, trembling, and sleeplessness.

The person may develop a rapid heartbeat, fever, and dilation of the pupils.

Sweating, confusion, hallucinations, and convulsions may also occur.

Treatment consists of rest, rehydration, and sedation.

Vitamin injections, particularly of thiamine (see vitamin B complex), may be given.... delirium tremens

A psychiatric illness characterized by chronic and persistent apprehension and tension that has no particular focus. There may also be physical symptoms such as trembling, sweating, lightheadedness, and irritability. The condition can be treated with psychotherapy or with drugs such as beta blockers, sedatives or tranquillizers that relieve symptoms but do not treat the underlying condition.

(See anxiety; anxiety disorders.)... generalized anxiety disorder

Involuntary trembling of the entire body that is caused by rapid contraction and relaxation of muscles. Shivering is the body’s normal automatic response to cold; contraction of muscles generates heat. Shivering also occurs in fever.... shivering

Hypoglycaemia or low blood sugar occurs when a patient with DIABETES MELLITUS suffers an imbalance between carbohydrate/glucose intake and INSULIN dosage. If there is more insulin than is needed to help metabolise the available carbohydrate, it causes a range of symptoms such as sweating, trembling, pounding heartbeat, anxiety, hunger, nausea, tiredness and headache. If the situation is not quickly remedied by taking oral sugar – or, if severe, giving glucose by injection – the patient may become confused, drowsy and uncoordinated, ?nally lapsing into a COMA. Hypoglycaemia is infrequent in people whose diabetes is controlled with diet and oral HYPOGLYCAEMIC AGENTS.

Treatment of acute hypoglycaemia depends upon the severity of the condition. Oral carbohydrate, such as a sugary drink or chocolate, may be e?ective if the patient is conscious enough to swallow; if not, glucose or GLUCAGON by injection will be required. Comatose patients who recover after an injection should then be given oral carbohydrates. An occasional but dangerous complication of coma is cerebral oedema (see BRAIN, DISEASES OF – Cerebral oedema), and this should be considered if coma persists. Emergency treatment in hospital is then needed. When the patient has recovered, management of his or her diabetes should be assessed in order to prevent further hypoglycaemic attacks.... hypoglycaemic coma

Multiple sclerosis is a progressive disease of the BRAIN and SPINAL CORD, which, although slow in its onset, in time may produce marked symptoms such as PARALYSIS and tremors (see TREMOR), and may ultimately result in a severely disabled invalid. The disorder consists of hardened patches, from the size of a pin-head to that of a pea or larger, scattered here and there irregularly through the brain and spinal cord. Each patch is made up of a mass of the CONNECTIVE TISSUE (neuroglia), which should be present only in su?cient amount to bind the nerve-cells and ?bres together. In the earliest stage, the insulating sheaths (MYELIN) of the nerve-?bres in the hardened patches break up, are absorbed, and leave the nerve-?bres bare, the connective tissue being later formed between these.

Cause Although this is one of the most common diseases of the central nervous system in Europe – there are around 50,000 affected individuals in Britain alone – the cause is still not known. The disease comes on in young people (onset being rare after the age of 40), apparently without previous illness. The ratio of women-to-men victims is 3:2. It is more common in ?rst and second children than in those later in birth order, and in small rather than big families. There may be a hereditary factor for MS, which could be an autoimmune disorder: the body’s defence system attacks the myelin in the central nervous system as if it were a ‘foreign’ tissue.

Symptoms These depend greatly upon the part of the brain and cord affected by the sclerotic patches. Temporary paralysis of a limb, or of an eye muscle, causing double vision, and tremors upon exertion, ?rst in the affected parts, and later in all parts of the body, are early symptoms. Sti?ness of the lower limbs causing the toes to catch on small irregularities in the ground and trip the person in walking, is often an annoying symptom and one of the ?rst to be noticed. Great activity is shown in the re?ex movements obtained by striking the tendons and by stroking the soles of the feet. The latter re?ex shows a characteristic sign (Babinski sign) in which the great toe bends upwards and the other toes spread apart as the sole is stroked, instead of the toes collectively bending downwards as in the normal person. Tremor of the eye movements (nystagmus) is usually found. Trembling handwriting, interference with the functions of the bladder, giddiness, and a peculiar ‘staccato’ or ‘scanning’ speech are common symptoms at a later stage. Numbness and tingling in the extremities occur commonly, particularly in the early stages of the disease. As the disease progresses, the paralyses, which were transitory at ?rst, now become con?rmed, often with great rigidity in the limbs. In many patients the disease progresses very slowly.

People with multiple sclerosis, and their relatives, can obtain help and guidance from the Multiple Sclerosis Society. Another helpful organisation is the Multiple Sclerosis Resources Centre. Those with sexual or marital problems arising out of the illness can obtain information from SPOD (Association to Aid the Sexual and Personal Relationships of People with a Disability). (See APPENDIX 2: ADDRESSES: SOURCES OF INFORMATION, ADVICE, SUPPORT AND SELFHELP.)

Treatment is di?cult, because the most that can be done is to lead a life as free from strain as possible, to check the progress of the disease. The use of INTERFERON beta seems to slow the progress of MS and this drug is licensed for use in the UK for patients with relapsing, remitting MS over two years, provided they can walk unaided – a controversial restriction on this (expensive) treatment. CORTICOSTEROIDS may be of help to some patients.

The NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE (NICE) ruled in 2001 that the use of the drugs interferon beta and glatiramer acetate for patients with multiple sclerosis was not cost-e?ective but recommended that the Department of Health, the National Assembly for Wales and the drug manufacturers should consider ways of making the drugs available in a cost-e?ective way. Subsequently the government said that it would consider funding a ‘risk-sharing’ scheme in which supply of drugs to patients would be funded only if treatment trials in individuals with MS showed that they were e?ective.

The Department of Health has asked NICE to assess two CANNABIS derivatives as possible treatments for multiple sclerosis and the relief of post-operative pain. Trials of an under-thetongue spray and a tablet could, if successsful, lead to the two drugs being available around 2005.

It is important to keep the nerves and muscles functioning, and therefore the patient should remain at work as long as he or she is capable of doing it, and in any case should exercise regularly.... multiple sclerosis (ms)

A ?ne involuntary movement. Tremors may be seen in projecting parts like the hands, head and tongue, or they may involve muscles. Coarse tremors, which prevent a person from drinking a glass of water without spilling it, are found in MULTIPLE SCLEROSIS (MS) and in CHOREA; somewhat ?ner tremors, which produce trembling of the hands or tongue when they are stretched out, are caused by alcoholism (see ALCOHOL) and other forms of poisoning, by PARKINSONISM, and by the weakness which follows some acute disease or characterises old age. A ?ne tremor of the outstretched ?ngers is a characteristic of thyrotoxicosis (see under THYROID GLAND, DISEASES OF); very ?ne tremors, visible in the muscles of face or limbs and known as ?brillary tremors, are present in general paralysis of the insane (see SYPHILIS), and in progressive muscular atrophy or wasting palsy. Tremors may occur at rest and disappear on movement as in Parkinsonism, or they may occur only on movement (intention tremors) as in cerebellar disease.... tremor

A group of drugs that widen the bronchioles (small airways in the lungs) to increase air flow and improve breathing, especially in the treatment of asthma and chronic obstructive pulmonary disease (see pulmonary disease, chronic obstructive). There are 3 main types of bronchodilator: sympathomimetic drugs (such as salbutamol), anticholinergic drugs, and xanthine drugs (such as aminophylline). Sympathomimetic drugs are used primarily for the rapid relief of breathing difficulty. Anticholinergic and xanthine drugs are more often used for the long-term prevention of attacks of breathing difficulty. Drugs can be given by inhaler, in tablet form, or, in severe cases, by nebulizer or injection.

The main side effects of sympathomimetics are palpitations and trembling.

Anticholinergics may cause dry mouth, blurred vision, and, rarely, difficulty in passing urine.

Xanthines may cause headaches, nausea and palpitations.... bronchodilator drugs

An abnormally low level of glucose in the blood. Almost all cases of hypoglycaemia occur in people with diabetes mellitus, in whom the pancreas fails to produce enough insulin, resulting in an abnormally high level of glucose. To lower the blood glucose level, hypoglycaemic drugs or insulin are given. Too high a dose of either can reduce the blood glucose to too low a level. Hypoglycaemia can also occur if a diabetic person misses a meal or takes strenuous exercise. Rarely, the condition can result from drinking too much alcohol or from an insulin-producing pancreatic tumour.

The main symptoms include sweating, hunger, dizziness, trembling, headache, palpitations, confusion, and sometimes double vision. Behaviour is often irrational and aggressive. Coma may occur in severe cases. Hypoglycaemia may also be the cause of seizures and jittery behaviour in newborns.

Sugar should be eaten at the first sign of a diabetic attack.

An injection of either glucose solution or the hormone glucagon may be given in an emergency.... hypoglycaemia

A brief period of acute anxiety, often dominated by an intense fear of dying or losing one’s reason. Attacks are unpredictable at first, but tend to become associated with specific situations, such as a cramped lift.

Symptoms (a sense of breathing difficulty, chest pains, palpitations, feeling light-headed, dizziness, sweating, trembling, and faintness) begin suddenly. Hyperventilation often occurs, causing a pins-and-needles feeling, and feelings of depersonalization and derealization. The attacks end quickly.

Panic attacks are generally a feature of an anxiety disorder, agoraphobia, or other phobias. In some cases, such attacks are part of a somatization disorder or schizophrenia. Behaviour therapy and relaxation exercises may be used in treatment of this condition.... panic attack

A term that is used to indicate the number of pregnancies a womanhas undergone that have resulted in the birth of a baby capable of survival. parkinsonism Any neurological disorder characterized by a mask-like face, rigidity, and slow movements. The most common type is Parkinson’s disease.

Parkinson’s disease A neurological disorder that causes muscle tremor, stiffness, and weakness. The characteristic signs are trembling, rigid posture, slow movements, and a shuffling, unbalanced walk. The disease is caused by degeneration of, or damage to, cells in the basal ganglia of the brain, reducing the amount of dopamine (which is needed for control of movement). It occurs mainly in elderly people and is more common in men.

The disease usually begins as a slight tremor of 1 hand, arm, or leg, which is worse when the hand or limb is at rest. Later, both sides of the body are affected, causing a stiff, shuffling, walk; constant trembling of the hands, sometimes accompanied by shaking of the head; a permanent rigid stoop; and an unblinking, fixed expression. The intellect is unaffected until late in the disease.

There is no cure.

Drug treatment is used to minimize symptoms in later stages.

Levodopa, which the body converts into dopamine, is usually the most effective drug.

It may be used in combination with benserazide or carbidopa.

The effects of levodopa gradually wear off.

Drugs that may be used in conjunction with it, or as substitutes for it, include amantadine and bromocriptine.

Surgical operations on the brain are occasionally performed.

Untreated, the disease progresses over 10 to 15 years, leading to severe weakness and incapacity.

About one third of sufferers eventually develop dementia.... parity

Unpleasant mental and physical symptoms experienced when a person stops using a drug on which he or she is dependent (see drug dependence). Withdrawal syndrome most commonly occurs in those with alcohol dependence or dependence on opioids, in smokers, and in people addicted to tranquillizers, amfetamines, cocaine, marijuana, and caffeine.

Alcohol withdrawal symptoms start 6–8 hours after cessation of intake and may last up to 7 days. They include trembling of the hands, nausea, vomiting, sweating, cramps, anxiety, and, sometimes, seizures. (See also confusion, delirium tremens, and hallucinations.)

Opioid withdrawal symptoms start after 8–12 hours and may last for 7–10 days. Symptoms include restlessness, sweating, runny eyes and nose, yawning, diarrhoea, vomiting, abdominal cramps, dilated pupils, loss of appetite, irritability, weakness, tremor, and depression.

Withdrawal symptoms from barbiturate drugs and meprobamate start after 12–24 hours, beginning with tremor, anxiety, restlessness, and weakness, sometimes followed by delirium, hallucinations, and, occasionally, seizures. A period of prolonged sleep occurs 3–8 days after onset. Withdrawal from benzodiazepine drugs may begin much more slowly and can be life-threatening.

Withdrawal symptoms from nicotine develop gradually over 24–48 hours and include irritability, concentration problems, frustration, headaches, and anxiety. Discontinuation of cocaine or amfetamines results in extreme tiredness, lethargy, and dizziness. Cocaine withdrawal may also lead to tremor, severe depression, and sweating.

Withdrawal symptoms from marijuana include tremor, nausea, vomiting, diarrhoea, sweating, irritability, and sleep problems. Caffeine withdrawal may lead to tiredness, headaches, and irritability.

Severe withdrawal syndromes require medical treatment.

Symptoms may be suppressed by giving the patient small quantities of the drug he or she had been taking.

More commonly, a substitute drug is given, such as methadone for opioid drugs or diazepam for alcohol.

The dose of the drug is then gradually reduced.... withdrawal syndrome