Diferencijalna dijagnostika tremora

master's thesis

• Title (english): Differential diagnosis of tremor
• Author: Tea Čubelić
• Mentor: Srđana Telarović (mentor)
• Committee member: Zdravka Poljaković-Skurić (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Srđana Telarović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Tremor je, prema definiciji, ritmički, oscilatorni pokret dijela tijela. Najčešći je poremećaj pokreta koji se susreće u kliničkoj praksi te može postojati kao samostalan klinički poremećaj ili može biti dio šireg spektra simptoma neke bolesti. S obzirom na brojne uzroke koji mogu dovesti do pojave tremora kao i sličnosti kliničkih obilježja među pojedinim vrstama, diferencijalna dijagnostika tremora je važna kako bi se utvrdio točan uzrok i ispravna terapija u procesu njegovog liječenja.

Često korištena klasifikacija tremora je klasifikacija prema kliničkoj prezentaciji te se s obzirom na aktivnost razlikuju dvije glavne skupine, tremor u mirovanju i tremor pri aktivnosti. Tremor pri aktivnosti uključuje posturalni, kinetički, tremor specifičan za zadatak i izometrički tremor. Tremor u mirovanju usmjerava dijagnozu prema Parkinsonovoj bolesti, međutim ovisi i o procjeni prisutnosti ostalih znakova parkinsonizma. Najčešći uzroci posturalnog tremora su esencijalni tremor, fiziološki tremor i tremor induciran lijekovima.

U diferencijalnoj dijagnostici treba razmotriti i manje česte uzroke poput distoničkog, psihogenog, cerebelarnog ili metaboličkog tremora uzrokovanog hipertireozom koje je također važno identificirati.

Potrebna je sveobuhvatna procjena bolesnika kako bi se postavila ispravna dijagnoza. Stoga je cilj ovog diplomskog rada pružiti pregled diferencijalne dijagnostike tremora, s naglaskom na kliničke karakteristike i dijagnostičke metode, koji će pomoći u razumijevanju različitih uzroka tremora što je ključan korak za daljnji odabir odgovarajuće terapije.

Abstract (english)

Tremor is, by definition, a rhythmic oscillatory movement of a body part. It is the most common movement disorder encountered in clinical practice and can exist as a stand-alone clinical disorder or may be part of a broader spectrum of symptoms of a disease. Given the numerous causes that can lead to the appearance of tremor as well as the similarities in clinical features among different types, differential diagnosis of tremor is important in order to establish the exact cause and appropriate therapy in the treatment process.

The often used classification of tremor is based on clinical presentation and distinguishes two main groups based on activity: tremor at rest and tremor during activity. Tremor during activity includes postural, kinetic, task-specific, and isometric tremor. Resting tremor directs the diagnosis towards Parkinson's disease, but also depends on the assessment of the presence of other signs of parkinsonism. The most common causes of postural tremor are essential tremor, physiological tremor, and drug-induced tremor.

Differential diagnosis should also consider less common causes such as dystonic, psychogenic, cerebellar or metabolic tremor caused by hyperthyroidism which is also important to identify.

A comprehensive patient assessment is needed to establish the correct diagnosis. Therefore, the aim of this thesis is to provide an overview of differential diagnosis of tremor, with an emphasis on clinical characteristics and diagnostic methods, which will help to understand the different causes of tremor and is a crucial step in further selecting appropriate therapy.

• Keywords: tremor; esencijalni tremor; Parkinsonova bolest; fiziološki tremor; psihogeni tremor; distonički tremor
• Keywords (english): tremor; essential tremor; Parkinson's disease; physiological tremor; psychogenic tremor; dystonic tremor
• Language: croatian
• URN:NBN: urn:nbn:hr:105:693860
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-23 13:03:23