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Started Having Head Tremors Yesterday That Seem To Originate In

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Posted on Tue, 11 Jun 2019
Question: Started having head tremors yesterday that seem to originate in my neck and make it tremor and turn to to the right. I had iron infusion of INJECTEFAR one week ago and I had side effects including nausea, migraine and two days ago severe itching down arm where they did the infusion. Went to pcp whosays the itching was a delayed reaction to the iron and to take hydroxizine. One dose and the itching stopped. I’ve also had severe fatigue and weakness. I was concerned because of the tremors that started yesterday. My pcp sent me to get labs today and my results were slightly high hemoglobin, hematocrit, red blood cells and alkaline phosphatase.

I do know the Injectefar can cause low phosphate/phosphorus but don’t know what relation that tests has to the ALP that was slightly high.

The reason for the iron infusion was unknown iron deficiency which only showed in low ferritin and low iron saturation.

Do I need the ER? Trying to avoid it unless necessary.

In addition I have vitamin D and vitamin B deficiency. I had gotten a b12 shot the same day as the Injectefar iron infusion which was on May9th

The tremor is bothersome and causeing the right side of neck go hurt because it turns that way. I do have a plate and screws in c5-c6 where I had a disectomy and fusion for herniated disc compressing canal. I also have herniations above and below it.

Just trying to give you the full picture and anything I can think of that may or may not relate.
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Follow up: Dr. Dr. Ashok Kumar Choudhary (11 minutes later)
In addition I have vitamin D and vitamin B deficiency. I had gotten a b12 shot the same day as the Injectefar iron infusion which was on May9th

The tremor is bothersome and causeing the right side of neck go hurt because it turns that way. I do have a plate and screws in c5-c6 where I had a disectomy and fusion for herniated disc compressing canal. I also have herniations above and below it.
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Follow up: Dr. Dr. Ashok Kumar Choudhary (1 minute later)
and fusion for herniated disc compressing canal. I also have herniations above and below it.

doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (6 hours later)
Brief Answer:
Consultation

Detailed Answer:
Hello,
Thanks for using Healthcaremagic.

I read your query and understand your concerns.

First of all regarding low phosphate and high alkaline phosphatase, I like to make it clear that both are completely related. When there is low phosphate due to any reason the possibility of high alkaline phosphatase will be there.

Now in regard to abnormal movements of your neck there is no data to suggest that the use of injectafer and abnormal head movements are related. It is well known that it can cause dizziness but the span of dizziness is limited for 3-7 days after use of injectafer. Since you have used the injection around 10 days back is it very unlikely the current abnormal head movements were caused by use of injectafer.

In regard to your question about visit to ER I feel it is better to visit as the description of movements points toward dyskinesia.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (5 hours later)
ok so can low phosohate cause tremors?

what avout low vitamin D as another doctor suggested?

since jts primarily my head and my neck could my neck herniations be causing it?

please point me in the right direction as far as tests to ask for.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (8 hours later)
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for reverting back to me.

Yes abrupt lowering of phospate can cause tremors as acute hypophosphatemia can cause tremors in additions to other neurological symptoms.

Vitamin D is also involved with phosphate metabolism and low level of vitamin D can cause low phosphate levels as the absorption of phosphates is regulated by vitamin D in addition to other factors.


I do not think herniations can be cause for acute tremors.

I hope this answers you further.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (16 hours later)
i agree that due to low D, slightly high ALP and that i have concerning symptoms including neurological that it is likely i have low Phosphorus. im not sure what do to at this time. i have chronically ill kids that need me so ER is difficult. do i contact primary or hematologist that infused the iron? i skept two days trying various XXXXXXX abd texhniques to calm the tremors ans to deal with severe weakness and fatigue. please give details as to what you think i should do and wgat tests fo ask for. thanks
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (5 hours later)
Brief Answer:
I think visiting your physician must be sufficient

Detailed Answer:
Hello,
Thanks for reverting back to me.

Since we are interacting over the last two days and no significant change took place in last two days (correct me if I am wrong) I feel visiting ER can be avoided at this time.

In addition we had a known cause for abnormal movements which is treatable even at the office of primary care physician, I feel visiting your PCP or treating doctor should be priority over the ER visit.

In regard to the tests most cases need only general physical examination and further tests can be planned depending on the physical examination, if necessary.

I hope this helps you further.
Feel free to write back to me if you have more questions.
Thanks and regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (25 minutes later)
today developed weakness worse in my legs that my primary confirmed. she saw trenors which ste also now in hands. thinks i medd ER but i didnt want that so she ordered magnesium amd vitamin D and hemayologist earlier ordered CMP, CBC and phosphorus. i also got am STAT MRI order from primary who thinks its MS. now im even mkre confused.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (32 hours later)
Brief Answer:
ER is a better option in the current scenario

Detailed Answer:
Hello,
Thanks for following up.

In view of newer symptom onset and involving distant areas of the body in addition to the primary area indicates that ER should be preferred over the wait and watch strategy.

In addition, the new symptoms indicate there is a need for complete neurological examination and as per my knowledge there is a long waiting list to visit neurologist, so waiting for a long time will be difficult.

I understand that you have hope responsibilities and other things to do but guess what happens if there is permanent damage to any area of the body. It will be much difficult to carry out all responsibilities in such a scenario.

I hope this helps you.
Feel free to write back to me if you have more questions.
Thanks and regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
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Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3347 Questions

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Started Having Head Tremors Yesterday That Seem To Originate In

In addition I have vitamin D and vitamin B deficiency. I had gotten a b12 shot the same day as the Injectefar iron infusion which was on May9th The tremor is bothersome and causeing the right side of neck go hurt because it turns that way. I do have a plate and screws in c5-c6 where I had a disectomy and fusion for herniated disc compressing canal. I also have herniations above and below it.