Tremore
Che cos’è il tremore?
Il tremore è un’ oscillazione ritmica e involontaria, che un segmento corporeo descrive intorno alla sua posizione di equilibrio, dovuta a contrazione ripetuta dei muscoli agonisti e antagonisti. I tremori sono presenti solo nello stato di veglia e scompaiono nel sonno. Può essere differenziato in tremore a riposo, tremore attitudinale e tremore intenzionale o d’azione.
Tremore a riposo
Compare quando il segmento (arti) è a riposo e si attenua quando l’arto compie un movimento volontario. E’ distale, interessa gli arti superiori, meno frequentemente quelli inferiori e la mandibola. È tipico della sindrome parkinsoniana.
Tremore nel morbo di parkinson
Tremore attitudinale
E’ assente a riposo e compare quando si mantiene una postura che attiva la muscolatura. Aumenta durante i movimenti di destrezza (ad es. scrivere). Interessa agli arti superiori, il volto, i muscoli faringo-laringei, (voce tremula). E’ ad ampie scosse che tendono, persistendo la postura, ad aumentare di ampiezza ed è più rapido del tremore a riposo. È presente in numerose patologie: ipertiroidismo, tossici esogeni (sali di litio, antidepressivi triciclici, acido valproico, sali di mercurio), stati ansiosi, neuropatie periferiche, sclerosi multipla. In assenza di tali patologie viene definito essenziale.
Tremore intenzionale o d’azione
Compare nella fase terminale di esecuzione di un movimento volontario, la cui traiettoria diventa discontinua a causa di oscillazioni successive di ampiezza crescente. È presente nelle patologie cerebellari e scompare con il riposo.
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