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Parkinson's Disease

Tremors

03/31/2008

Question:

Dear Sirs,

First I hope this question may go under this topic as could not find a specific one. I also apologize for the length. I am currently working in South east Asia and will not have an opportunity to go for a doctors visit soon. I hope you might be of help. I believe I have what you call “intentional tremors”. I first remember my right hand shaking after a car accident at the age of eight, whether it was due to the accident I have no idea but I was not seriously hurt. Since then, I’m 25, it has worsened to a point that not only does my left hand also shake but at times my whole body as well. I read everything on this site about tremors but can’t find an exact comparison. I have learned to deal with it but the tremors are constant and have worsened, I can no longer hold a coffee cup without spilling or dropping the teaspoon. I quit smoking, drinking coffee and almost all alchohol. I exercised regularly, but find that any body effort, such as a sit-up will make my body shake. I have come to a point that writing becomes impossible at times, especially if nervous, tired, or stressed. But no matter how relaxed my shaking is always there. My voice also tends to sound like opera. From what I understand this isn’t unique, and having been to quite a few doctors they all inform me that the human brain does things we don’t understand. I however hoped that together with my other symptoms I might be able to find something to help, if not cure, me. Since I was a kid I have also had regular migraines together with the even more regular headaches. I also have quite irregular insomnia, I will sleep quite normally for 2 days and then will have difficulty sleeping even a couple hours for the next several nights. My vision is not perfect but barely need glasses yet at times cannot keep focus on anything and have to look away and closing my eyes is makes it worse..it is like the feeling when you try to concentrate on fast moving objects passing close to the window while on a train.Only this happens for several minutes and even in a closed room. Though I doubt they enter as symptoms,. I eat regularly with a good mixed diet but have trouble gaining weight, rarely feel the need to go to the bathroom (5 days at times, with no consequences), memory problems, and have some (also apparently incurable) skin reactions on scalp and facial hair areas. As I said I’ve been to doctors, had MRI and other neurological tests but with no results. I have had all the above for at least 10 years…but the worsening of the tremors is too much. If there is any advice I would be extremely grateful.

Answer:

Tremor may be a primary condition or a feature of a syndrome. Primary tremor includes exacerbated physiological tremor and benign essential tremor. Tremor as part of a syndrome or other condition includes Parkinsonian tremor, metabolic disturbance, drug-induced tremor. Other secondary causes of tremor include some hereditary diseases, injuries and demyelinating disease such as multiple sclerosis. It is impossible to clarify your condition from this forum. It is important to seek the advice of a movement disorders neurologist to get a full assessment.

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Response by:

Punit  Agrawal, DO Punit Agrawal, DO
Assistant Professor of Neurology
College of Medicine
The Ohio State University