...
When does the tremor occur? Intention tremor, which means that the tremor occurs on movement, would suggest that the patient is suffering from a ... DIAGNOSTIC WORKUP
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Chorea (Greek for “dance”) refers to continuous, rapid, and abrupt jerking movements, which are involuntary and often possess a writhing quality. These movements often interfere with the ability to complete daily... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Seizures are a symptom of some identifiable underlying cause or are idiopathic. Epilepsy is recurrent unprovoked seizures. Seizures may or may not be associated with convulsive activity. Correct... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Tremors are abnormal, rhythmic, involuntary movements. They are classified as resting and intention or action tremors, the former occurring at rest (resting tremor) or in a static position (postural tremor), such as when... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Chorea consists of brief, irregular, nonrhythmic, unsustained involuntary movements that flow from one part of the body to another. Chorea is often accompanied by athetosis, which are slow, writhing, involuntary... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Distal weakness is most likely secondary to neuropathy, and is often associated with loss of deep tendon reflexes (DTRs) either with or without sensory abnormalities. In contrast, increased DTRs or... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Proximal weakness is usually due to dysfunction of the lower motor unit; that is, anterior horn cells in the spinal cord, neuromuscular junction (NMJ), or the muscle itself. The neurologic... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Febrile seizures occur in 3–4% of all children; they often do not require long-term treatment. Each year, between 25,000 and 40,000 children in the U.S. have a first... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Seizures in the newborn are often difficult to diagnose, because there may only be subtle manifestations. Any insult that affects the brain in this age group can present with seizures, thus... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The causes of this symptom lend themselves easily to recall. Simply remember the word VINDICATE. There are usually just one or two diseases for each letter.
V—Vascular suggests an infarct of the subthalamic
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... This sign is generally considered pathognomonic for anterior horn cell or root disease. It may occur, however, in certain cases of peripheral neuropathy, in electrolyte disturbances, and in
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... The differential diagnosis of this sign is similar to the differential diagnosis of tremors (see page 521), but a few additional possibilities should be kept in mind. Idiopathic myoclonus epilepsy, petit mal epilepsy (with the
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... Anatomy can assist one greatly in formulating a differential diagnosis of tremor of hepatic coma, Wilson disease, and alcoholism. The thyroid brings to mind the tremor of Graves disease. The kidneys
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... Fasciculations are local muscle contractions representing the spontaneous discharge of a muscle fiber bundle innervated by a single motor nerve filament. These contractions cause visible dimpling or wavelike twitching of the... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots, peripheral... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald the onset of a seizure. These contractions may... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system neurons, leading to neurologic dysfunction. Unlike most other types... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... The most common type of involuntary muscle movement, tremors are regular rhythmic oscillations that result from alternating contraction of opposing muscle groups. They’re typical signs... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Muscle spasms are strong, painful contractions. They can occur in virtually any muscle, but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during pregnancy. However, they... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient’s fear or... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... A bilateral, coarse movement, asterixis is characterized by sudden relaxation of muscle groups holding a sustained posture. This elicited sign is most commonly observed in the wrists and... Emergency interventions ... Medical causes ... Other causes ... Special considerations
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... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times per... History and physical examination ... Medical causes
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... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness — usually confusion. Psychomotor seizures can occur at any age, but their incidence usually... History ... Medical causes ... Special considerations ... Pediatric pointers
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... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Acute or Subacute*
Electrolyte abnormality
Hyperkalemia
Hypokalemia
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... Central Nervous System and Vascular Causes
Cerebrovascular disease
Thrombosis
Embolism
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... Tremor at rest (present at rest, decreased with movement)
Parkinson's disease
Postencephalitic parkinsonism
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... Fasciculations are local muscle contractions representing the spontaneous discharge of a muscle fiber bundle innervated by a single motor nerve filament. These contractions... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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Myoclonus
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Myoclonus—sudden, shocklike contractions of a single muscle or muscle group—occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic,... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Tremors
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... The most common type of involuntary muscle movement, tremors are regular rhythmic oscillations that result from alternating contraction of opposing muscle groups. They’re typical signs of extrapyramidal or... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Muscle spasms are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during pregnancy. However... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient’s fear... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A bilateral, coarse movement, asterixis is characterized by sudden relaxation of muscle groups holding a sustained posture. This elicited sign is most commonly observed in the wrists and fingers... Emergency interventions ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Chorea—brief, unpredictable bursts of rapid, jerky motion that interrupt normal coordinated movement—indicates dysfunction of the extrapyramidal system. Unlike tics, choreiform movements are... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times a day,... History and physical examination ... Medical causes ... Patient counseling
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... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness—usually confusion. Psychomotor seizures... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and pattern reflect the location of the... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Seizures
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Linda M. Savory
Seizures are a common serious neurologic disorder in the outpatient setting. In the United States, approximately 4 million patients suffer at least one seizure and 2... Approach. ... History. ... Physical examination (PE) ... Testing ... Diagnostic assessment.
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Tremor
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Peter G. Teichman
Tremor, a rhythmic, involuntary oscillatory movement of a body part, is the most common movement disorder.
Approach. It is important to classify the tremor based on clinical... History ... Physical examination. ... Testing. ... Diagnostic assessment.
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... Differential Overview
❑ Generalized (grand mal)
❑ Partial (focal)
❑ Complex... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Tremor
❑ Anxiety
❑ Physiologic tremor
❑ Essential tremor
... Diagnostic Approach ... Clinical Findings ... Pictures
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Fasciculations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Fasciculations are local muscle contractions representing the spontaneous discharge of a muscle fiber bundle innervated by a single motor nerve filament. These contractions cause visible dimpling or wavelike twitching of the skin, but... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Myoclonus
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Muscle spasms
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Muscle spasms are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot. Muscle spasms typically occur from simple muscle fatigue, after exercise, and during... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Chorea
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... Chorea — brief, unpredictable bursts of rapid, jerky motion that interrupt normal coordinated movement — indicates dysfunction of the extrapyramidal system. Unlike tics, choreiform movements are seldom repetitive but tend to... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord,... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Tremors
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... The most common type of involuntary muscle movement, tremors are regular rhythmic oscillations that result from alternating contraction of opposing muscle groups. They’re typical signs of extrapyramidal or... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Muscle spasms, or muscle cramps, are strong, painful contractions. They can occur in virtually any muscle but are most common in the calf and foot. Muscle spasms typically occur from simple... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness — usually confusion. Psychomotor seizures can occur at any age, but incidence usually... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Seizures
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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... A seizureis a sudden paroxysmal discharge of neurons that causes a transientalteration in neurologic function. This alteration can include changesin level of alertness, sensation, motor activity, and autonomicfunction. ... Classification of Seizure Types ... Principal Causes of Seizures ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Fasciculations, or muscle twitches, are local muscle contractions caused by the spontaneous discharge of a muscle fiber bundle supplied by a single motor nerve cell. These contractions cause... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Muscle weakness is detected by observing and measuring the strength of an individual muscle or muscle group. It can result from a malfunction in the cerebral hemispheres, brain stem, spinal cord, nerve roots,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Myoclonus—sudden, shocklike contractions of a single muscle or muscle group—occurs with various neurologic disorders and may herald the onset of a seizure. These contractions may be isolated or... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... The most common type of involuntary muscle movement, tremors are regular rhythmic oscillations that result from alternating contraction of opposing muscle groups. They're typical signs of extrapyramidal or... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Muscle spasms are strong, painful contractions of the muscles. They can occur in virtually any muscle, but are most common in the calf and foot. Muscle spasms typically occur from... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Detected by palpation, abdominal rigidity refers to abnormal muscle tension or inflexibility of the abdomen. Rigidity may be voluntary or involuntary. Voluntary rigidity reflects the patient's fear or... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... A bilateral, coarse movement, asterixis is characterized by sudden relaxation of muscle groups holding a sustained posture. This elicited sign is most commonly observed in the wrists and fingers, but may also appear during any... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times per day, causing... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness—usually confusion. Psychomotor seizures can occur at any... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ MEDICAL BOOK EXCERPTS ONLINE » (free access, no registration)
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don't alter the patient's level of consciousness (LOC). The type and pattern reflect the location of the... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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...
The causes of this symptom lend themselves easily to recall. Simply
remember the word VINDICATE. There are usually just one or two
diseases for each letter.
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...
This sign is generally considered pathognomonic for anterior horn cell
or root disease. It may occur, however, in certain cases of peripheral
neuropathy, in electrolyte
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...
The differential diagnosis of this sign is similar to that of tremors
, but a few additional
possibilities should be kept in mind. Idiopathic myoclonus epilepsy, petit
mal epilepsy (with the petit mal
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...
Anatomy can assist one greatly in formulating a differential
diagnosis of tremor of hepatic coma, Wilson disease, and alcoholism. The
thyroid brings to mind the tremor of Graves disease. The
... Pictures
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