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I've Started To Notice A Postural Tremor In My Right

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Posted on Mon, 7 Sep 2020
Question: I've started to notice a postural tremor in my right arm and hand specifically when I lift up my arm or flex my wrist for any extended period of time (like when typing or talking on the phone, etc.). Prior to all this, I saw a neuro regarding pain on the same side that occured from my right shoulder down to the right foot. He did an MRI that came back normal and told me it was likely due to anxiety. Regarding the tremor, there's been no development of weakness that I've been able to notice, just this shakiness that only occurs with exertion. I saw my GP who did a standard clinical neurological exam and said there was nothing remarkable to note, but I'm very worried that this may be the onset of something serious like Parkinson's or ALS; especially since it's only occurring on one side. I'm 31, Transfemme. Any advice you could give would be greatly appreciated as this is causing me a great deal of anxiety. Could these issues be related? Does this sound like onset of Parkinson's of ALS? Thank you!
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Answered by Dr. Olsi Taka (6 hours later)
Brief Answer:
Doesn't sound like Parkinson or ALS

Detailed Answer:
I read your question carefully and I understand your concern.

Based on what you describe I do not see an indication of any serious neurological condition. Regarding the conditions you mention I don't think any of those is the case. Apart from your age (which alone makes both of them very unlikely) the symptoms are not typical either. In Parkinson's the tremor is not postural but rest tremor, usually there are other symptoms noted on neurological examination as well.
As for ALS, tremor is not an ALS symptom, certainly not the presenting symptom. It typically manifests with weakness which would also be noted on neuro exam, accompanied with muscle atrophy. The fasciculations, muscle twitches, of ALS are different from tremor.
So if neurological exam is normal I would not worry about that isolated tremor, it may be related to anxiety.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3672 Questions

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I've Started To Notice A Postural Tremor In My Right

Brief Answer: Doesn't sound like Parkinson or ALS Detailed Answer: I read your question carefully and I understand your concern. Based on what you describe I do not see an indication of any serious neurological condition. Regarding the conditions you mention I don't think any of those is the case. Apart from your age (which alone makes both of them very unlikely) the symptoms are not typical either. In Parkinson's the tremor is not postural but rest tremor, usually there are other symptoms noted on neurological examination as well. As for ALS, tremor is not an ALS symptom, certainly not the presenting symptom. It typically manifests with weakness which would also be noted on neuro exam, accompanied with muscle atrophy. The fasciculations, muscle twitches, of ALS are different from tremor. So if neurological exam is normal I would not worry about that isolated tremor, it may be related to anxiety. I hope to have been of help.