This book describes Post-stroke Tremors, Diagnosis and Treatment and Related Diseases

After a stroke, tremors in my patients are frequent, particularly in the hands and arms.

This is due to small vessel obstruction of the brain in the areas responsible for voluntary muscle contraction.

Tremors due to a stroke will normally resolve on their own within six months but may be improved with physical therapy or medication.

Post-Stroke Tremors are featured by rhythmic, unintentional shaking.

Tremors are not the only disorder that can produce unintentional movement disorders after stroke

Movement disorders are a rare complication of strokes that can be hyper-kinetic or hypo-kinetic.

They can happen with damage to many different areas in the motor pathway, most often basal ganglia and thalamus.

Some tremors are self-limiting but treatment may be necessary to control the symptoms.

It is important for the doctor to obtain an accurate diagnosis.

A tremor is a repeated and unmanageable movement in some part of the body.

It is not area specific, meaning that it can happen at any site in the body.

While tremors have a range of causes, it normally results from a problem in the area of the brain that regulates the body movements.

While they are not always a symptom of something serious, they can be a sign that something is wrong in the brain.

The patient must keep in mind that muscle spasms and tremors are not similar.

The muscle spasms happen in the muscles, while tremors result from problems in the brain.

Post-Stroke Tremors are not the most frequent happening involuntary movement disorder (chorea is the most frequent).

When tremors do happen after stroke, they are often due to brain damage from a stroke in the thalamus or basal ganglia.

The basal ganglia have a part in a range of functions such as control of voluntary movement, which also requires inhibiting competing movements that might disrupt the desired movement.

The thalamus has a part in transmitting motor signals to the cerebral cortex.

As the patient can determine, the damage to these areas of the brain can produce disorders with involuntary movements, like tremors.

When the patient has tremors, the patient may realize that a part of the body is moving uncontrollably.

Depending on the cause of the tremors, the patient might notice other symptoms such as:

Tiredness

Anxiety or restlessness

Trouble walking, talking, and speaking

After a stroke, essential tremors are most often observed in the hands and arms.

This is the time when some stroke patients observe their hand shaking after stroke.

These post-stroke tremors are different from muscle spasms and twitch which are a sign of spasticity.

If a stroke patient develops tremors, they normally start months after the stroke.

Of all the involuntary movement disorders that happened after a stroke, tremor has the longest delayed start.

Due to this delayed onset, it can be difficult to diagnose the cause of the tremors since new disorders may have developed.

The treatment for post-stroke tremors may only slow the progression.

There is always hope for partially or fully resolving tremors after stroke since 90% of post-stroke tremors resolve on their own within 6 months.

Treatment for Post-Stroke Tremors:

Physical, speech and occupational therapy

Medication

Beta-blockers

Anti-seizure

Baclofen

Botox Injections

Behavioral Relaxation Training

Surgery

Deep Brain Stimulation

Thalamotomy

Radiofrequency ablation

TABLE OF CONTENT

Introduction

Chapter 1 Post-Stroke Tremors

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Stroke

Chapter 8 Tremors

Epilogue