A septuagenarian retired teacher living in Greater Kaohsiung, who is also a talented calligraphist, started suffering from involuntary tremors in both hands around a year ago, forcing him to give up his hobby of 40 years. He was initially worried he had Parkinson’s disease, but that was ruled out after seeing a doctor, who eventually diagnosed him with degenerative tremors that affect elderly people. His condition improved significantly after taking medication, and he was able to take up the brush again.
Lin Tsu-kung, head of the Department of Neurology at Kaohsiung Chang Gung Memorial Hospital, says that degenerative tremors and Parkinson’s disease are two different types of diseases, and that from clinical studies it is apparent that when a certain position or posture is maintained, involuntary tremors occur when, for example, holding out one’s hand, holding something, or holding a spoon to eat soup. The head may also make back and forth motions when talking. The cause, however, is unknown.
Lin says that Parkinsonian tremors, on the other hand, will still occur even when a person is resting. For example, a person’s hand will twitch while watching TV, accompanied by stiff, slow movements and loss of balance, all of which is caused by cerebral disease. Although it can be controlled with treatment, it cannot be cured.
Photo: Fang Chih-hsien, Liberty Times
照片：自由時報記者方志賢
Common physiologic tremors can occur when people get nervous, angry, excited or when caffeine is consumed.
The doctor gave the retired teacher a CT scan to ensure that there were not any problems in the brain. In addition, he was not suffering from alcoholism or taking medicine for asthma or epilepsy.
Lin says that degenerative tremors usually occur in people 60 years of age or older, and that half of all cases are hereditary and do not cause damage to the nervous system or one’s physical health, but if the tremors affect one’s social life or daily habits, the patient may be given beta blockers or depressants. Although it cannot be completely controlled, there is usually around a 60 percent improvement seen in a person’s condition when given beta blockers.
Photo: Fang Chih-hsien, Liberty Times
照片：自由時報記者方志賢
The retired teacher saw vast improvements in his tremors after taking medication, and he was finally able to return to his calligraphy hobby.
(Liberty Times, Translated by Kyle Jeffcoat)
高雄一名七十多歲退休老師，寫得一手好書法，一年前雙手不自主顫抖，維持四十多年的寫字興趣被迫中斷，他一度憂心罹患巴金森氏症，就醫後排除，醫師診斷他是老年退化性顫抖，服用藥物治療後，顫抖症狀改善，重拾寫毛筆字的興趣。
高雄長庚醫院神經內科系主任林祖功醫師表示，退化性顫抖與巴金森氏症是兩種不同疾病，從臨床表現來看，退化性顫抖是在維持固定姿勢，例如手伸直、拿東西或拿湯匙喝湯時會不自主顫抖，還有人講話頭會左右搖晃，致病原因不明。
林祖功說，巴金森氏症引起的顫抖，就算人體在休息的狀態仍會發生，例如看電視時手一直抖，伴隨肢體僵硬、動作緩慢、平衡失調等症狀，這是小腦病變引起，經過治療雖然能控制，但是仍無法根治。
常見的顫抖還有生理性顫抖，因緊張、生氣、興奮或咖啡因刺激引起。
醫師也為老先生做電腦斷層檢查，確認腦部沒有問題，患者也無酗酒及服用氣喘、癲癇等藥物。
林祖功表示，退化性顫抖好發於六十歲以上長者，有一半屬於家族遺傳，不會傷害神經系統及身體健康，但若影響到社交關係、生活作息，給予乙型阻斷劑（β–blockers）或鎮定劑治療，雖然無法完全控制，但能改善六成以上。
這名退休老師服藥治療後，顫抖症狀明顯改善，也恢復寫書法的興趣。
(自由時報記者方志賢)
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