Also known as tremor paralysis. It is a disease of unknown cause involving extrapyramidal degeneration and dysfunction of dopamine-cholinergic nerves.

bubble_chart Diagnosis

1. Slow onset after the age of 50, gradually worsening.

2. Main manifestations include:

(1) Pill-rolling resting tremor in one or both limbs, occurring 4 to 8 times per second, reduced during voluntary movement, aggravated by emotional tension, and disappearing during sleep.

(2) Increased muscle tone in the limbs, presenting as lead-pipe or cogwheel rigidity, with a stiff facial expression resembling a "mask-like face."

(3) Slow movements, reduced postural reflexes, and a shuffling gait while walking. Possible "micrographia," slow speech, and monotonous, low-pitched voice.

(4) Possible difficulties with urination and defecation, increased sweating, seborrhea, orthostatic hypotension, psychiatric symptoms, and dementia.

(5) Cranial CT may show widened sulci and enlarged ventricles.

bubble_chart Treatment Measures

1. Drug Therapy

(1) Levodopa. Start with 125mg, 1-2 times/day, increasing by 125mg every 4-7 days until symptoms are controlled and tolerated. The maintenance dose is 2.5-6g/day, divided into 4-6 doses.

(2) Madopar. Each tablet contains 100mg of levodopa and 25mg of benserazide. In the first week, take 1 tablet 3 times/day; increase to 4 times/day in the second week; starting from the third week, increase the single dose every 1-2 weeks until efficacy is achieved. The maintenance dose is approximately 8 tablets/day.

(3) Sinemet. Each tablet contains 100mg of levodopa and 10mg or 25mg of carbidopa. Start with 1 tablet 3 times/day, then increase by 1 tablet every 2 days, with a maximum daily dose of 6-8 tablets.

(5) Other medications. Such as amantadine, trihexyphenidyl, diphenhydramine, propranolol, etc.

2. Surgical Treatment

For younger patients without brain atrophy and those unresponsive to drug therapy, stereotactic brain surgery or adrenal medullary brain transplantation may be performed.

3. Body Acupuncture or Scalp Acupuncture Therapy.

bubble_chart Differentiation

It needs to be differentiated from Parkinson's syndrome caused by encephalitis, cerebrovascular disease, poisoning, trauma, as well as hysterical, tension-induced, and senile tremors.