What can cause tremor myotonia, bradykinesia

       Tremor palsy, also known as Parkinson’s disease, is a common neurodegenerative disease that develops after middle age and is characterized by resting tremor, muscle tonicity, and bradykinesia.  The cause is unknown, but it is thought to be related to ageing, environmental factors or family genetic factors. Secondary causes include cerebrovascular disease (e.g., lacunar infarction), pharmacogenic (e.g., use of phenelzine or butylphenyl antipsychotics), poisoning (carbon monoxide, manganese, mercury, etc.), encephalitis, traumatic brain injury, brain tumors, and basal ganglia calcification.  The disease mostly occurs after 50 years of age, about 3/4 patients start between 50 and 60 years of age, with a family history of a younger age of onset, the disease is insidious, slowly progressive aggravation, with tremor, muscle tonicity and bradykinesia as the main clinical manifestations.  1, tremor: tremor mostly starts from one side of the upper limb hand, showing rhythmic pill-rolling-like movements. As the disease progresses, the tremor gradually spreads to the ipsilateral lower limb and the contralateral upper and lower limbs, usually with the limbs heavier than the lower limbs, and the tremor of the jaw, mouth, lips, tongue and head mostly appear in the later stage of the disease. The tremor mostly appears at rest, decreases during casual activities, increases during emotional stress, and disappears after sleep.  2. Myotonicity: The muscle tension of the whole body is increased. The limbs are called leadpipe-like ankylosis because of the increased tension of the extensor and flexor muscles, resulting in uniform and consistent impedance when the joints are passively extended and flexed, and the impedance has intermittent pauses if accompanied by tremor, which is called gear-like ankylosis. The facial muscle tone is increased and the expression appears dull and mask-like.  3.Sluggishness of movement: It is difficult to start random movement, slow movement and reduced activity. Patients appear to be clumsy and slow in turning over, standing up, walking and turning, and have difficulty in dressing, combing hair, brushing teeth, etc. When writing, the handwriting falters or becomes smaller and smaller, which is called writing too small. Walking slowly, the pace is small, the feet can barely leave the ground, walking loses its center of gravity, often walking faster and faster in the form of a forward rush, can not stop immediately, called panic gait. When walking, the postural reflexes are impaired and there is a lack of synergistic movement of the upper limbs.