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What Causes An Uncontrollable Shaking In The Body?
Question: I have familial tremors. Not so bad yet, but I can see changes in myself. My Maternal grandmother, my mom and my younger sister had/have it really bad. They were bad enough, that it was near impossible to eat without using a spoon, and then they would spill half the food on themselves. I thought I had lucked out, except coworkers from the early 90's would ask me why my hands were shaking, and I would tell them then, there was nothing wrong.
Well, it has finally caught up with me. I have really seen it in my handwriting. It used to be very nice, but now it mostly looks like chicken scratch! Even my printing has gone downhill. Also my left pinky finger and all the nerves right next to it, are virtually numb. And Last but not least, over the past year or so, the nerve endings in my lower legs (knee down, both legs) feel as though they are on fire when touched. I will see a neurologist soon, since other problems have been showing up. I was just hoping to get in while it is still mild, and see if/how long I can stay off medication
Thank you for listening.
XXXX.
Well, it has finally caught up with me. I have really seen it in my handwriting. It used to be very nice, but now it mostly looks like chicken scratch! Even my printing has gone downhill. Also my left pinky finger and all the nerves right next to it, are virtually numb. And Last but not least, over the past year or so, the nerve endings in my lower legs (knee down, both legs) feel as though they are on fire when touched. I will see a neurologist soon, since other problems have been showing up. I was just hoping to get in while it is still mild, and see if/how long I can stay off medication
Thank you for listening.
XXXX.
Brief Answer:
Essential tremor most likely
Detailed Answer:
I read your question carefully and I understand your concern.
Based on your description of slowly progressing tremor over the years with a strong family history I would say that the most probable diagnosis is essential tremor. It is a benign tremor, involving both sides, an action tremor meaning more marked when trying to perform various actions and less noticeable at rest, often increased by anxiety. It is benign in the sense of not meaning any threat to your life, but over the years it causes disability as you yourself say about your relatives having difficulty even when eating.
A neurological consult is still necessary to check for presence of some other neurological sign which you may have not noticed (like Parkinson's signs for example), also some blood tests to check for causes such as electrolyte alterations, or thyroid dysfunction are necessary (if not already done before during the check-ups you seem to have had for other purposes).
As for treatment the most commonly employed are Propranolol (a drug more know for its use for hypertension, but effective also for essential tremor) or Primidone (a drug in the past know as an antiepileptic, but now used mainly for essential tremor).
In terms of efficacy they do not have major differences between them, the choice is dictated mainly from the risk for side effects and interactions. In your case particular care is needed, because you seem to take many drugs, both for hypertension as well as acting on central nervous system, so there are several interactions to consider, perhaps for Primidone the opinion of the psychiatrist may be needed to for the possibility of altering the dosage of one of your other drugs.
I remain at your disposal for further questions.
Essential tremor most likely
Detailed Answer:
I read your question carefully and I understand your concern.
Based on your description of slowly progressing tremor over the years with a strong family history I would say that the most probable diagnosis is essential tremor. It is a benign tremor, involving both sides, an action tremor meaning more marked when trying to perform various actions and less noticeable at rest, often increased by anxiety. It is benign in the sense of not meaning any threat to your life, but over the years it causes disability as you yourself say about your relatives having difficulty even when eating.
A neurological consult is still necessary to check for presence of some other neurological sign which you may have not noticed (like Parkinson's signs for example), also some blood tests to check for causes such as electrolyte alterations, or thyroid dysfunction are necessary (if not already done before during the check-ups you seem to have had for other purposes).
As for treatment the most commonly employed are Propranolol (a drug more know for its use for hypertension, but effective also for essential tremor) or Primidone (a drug in the past know as an antiepileptic, but now used mainly for essential tremor).
In terms of efficacy they do not have major differences between them, the choice is dictated mainly from the risk for side effects and interactions. In your case particular care is needed, because you seem to take many drugs, both for hypertension as well as acting on central nervous system, so there are several interactions to consider, perhaps for Primidone the opinion of the psychiatrist may be needed to for the possibility of altering the dosage of one of your other drugs.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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