Discover and read the best of Twitter Threads about #tremor

Most recents (6)

Shaking of hands: Essential tremor (ET) or Parkinson's disease (PD)

1. Shaking of hands (tremors) are common. The usual question among patients (and doctors) is what is the root cause- ET or PD?
Here I would highlight the clinical differences between the two.
#MedTwitter
2. ET affects both hands, whereas PD affects one hand (asymmetric ET- one hand more affected than other & unilateral ET- affecting only one hand can rarely occur).
If tremors remain confined to one hand for >3 years, one should look for structural brain disease (unusual for PD).
3. Tremor in ET is brought on by doing an activity (holding a cup of coffee or writing), whereas people with PD have resting tremors.
Tremors in ET can be better seen with outstretched arms and hands.
Tremors in PD can be better seen by distracting the patient (and observing).
Read 10 tweets
When cheque bounced due to signature mismatch

1. 48-yr old Venky was surprised when two of the cheques issued by him bounced due to signature mismatch. On enquiry with bank staff, he was shown his original signature, which did not match with the current one.
#MedTwitter
2. It was noted that letters in the later half of his signature had reduced in height (as compared to height in his original signature). The legibility of his writing too had reduced. He tried writing at home & similar thing happened- letters became smaller as he wrote sentences.
3. Venky decided to consult a Neurologist for evaluation. I reviewed his history.
He showed me his writing. Attached below are the samples- (above is normal, the one below is what his writing looked like).
I also observed mild shivering of his right hand, while he spoke to me. Image
Read 11 tweets
Thread Alert 🧵: Let's talk about Parkinson's Disease 1/25 #Parkinsons #neurotwitter
In 2005 there was this study that, although very small, showed benefits. "Unified Parkinson’s Disease Rating Scale scores improved in all five during hyperketonemia" 2/25
n.neurology.org/content/64/4/7…
It wasn't designed to rule out a placebo effect. But the result should have resulted in excitement and further studies being done. 3/25
Read 25 tweets
Massive 6.4 #earthquake rocks #California leaving people without power | Dec 20
- Its #epicenter was 210 miles north of #SanFrancisco, where a quake hit last week
dailymail.co.uk/news/article-1…
6.4-Magnitude #Earthquake Hits Northern #California | -3h
Northern #California #earthquake causes 'widespread damage' to roads, homes | -2h
Read 56 tweets
Functional Gait disorders ("FGD" for the purpose of this #twittorial) are common and disabling, usually accompanied by other symptoms. FGD are challenging for the non #MovDis physician and it can difficult to determine #inconsistencies and #incongruencies during examination.
2/
A good approach is to identify #clinicalSigns to differentiate a #functional vs #organic cause

#Inconsistency is the variability in gait disorder severity over time.
#incongruency involves a combination of symptoms and sins not seen in organic disorders.
#distractibility
3/
Read 19 tweets
Is it time for #NeuromuscularQandA? Questions you always wanted to ask your friendly #neuromuscular doc. RT. #neurology #medtwitter #MedEd #medstudent #neurologyresident Short answers only. Join me in discussing/learning/educating with #passion and #humor @WNGtweets @somedocs
A: Judge the tongue by the company it keeps. If it’s weak and wasted it ain’t tremor. #Musk myasthenia gravis and #ALS tongues may be weak and wasted with fasciculations. So try #steriods - If it responds to steroids it ain’t ALS - gotta be #MG. #clinicaldiagnosis
Read 4 tweets

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