Brief Answer:
Not a neurology problem.Need investigations & management with expert help

Detailed Answer:
HI XXXX,
Thanks for your query through HCM platform.
Diabetes & Myestheniagravis at age of 82, itself becomes make life dependent. Addition of shaking along with cold feeling to it is naturally adding to concern. I understand it. Please don't worry, finding the basic cause along with proper medication & self help would definitely control it.
There are a number of cases causing shakyness & cold feeling separately. But in your case I feel most probable causes for your cold shakiness seem to be out of--
- Myesthenia gravis itself/ uncontrolled diabetes/ Probable thyroid condition / Intense hunger/ nervousness.
- Intense hunger - can cause shaky body & cold feeling. It is possible in your case because of the diabetes, which can produce spells of hunger.- excessive dose of medication is liable to cause it.( hypoglycemia )
- Nervousness- psychological stress due to the condition will lead to the symptoms ( in such a case fast heart beats also accompany)
- Hypothyroidism- It is a common auto immune association with diabetes & myestheniagravis. Low level of thyroid hormone has typical symptom of cold feeling along with fatigue . Total effect of the triad ( Diabetes,
Myestheniagravis, Hypothyroidism) produce shakiness & cold feeling.
* I don't think it can be neurology problem as
- Neurological symptoms can be due to affection of nerve at spinal level, Pressure on individual nerve,... here symptoms are sensory & motor loss.. in a part of body. It can not cause body shaking.
- Neurological involvement due to systemic diseases like Diabetes.. is usually seen only at peripheral part of body & usually in form of sensory loss.
So neurological cause does not seem to be possible for your symptoms.
** In this context I would advise
- for re evaluation of your treatment plan under guidance of your doctor & change the dosage/ medication as per need.
- Getting thyroid function tests done to exclude/ confirm thyroid problem & get necessary specific treatment with help of an Endocrinologist.
* Self help.- - Try to be positive. Use psychological concentration/ meditation methods/ psychotherapy for that.
- Have intermittent mild exercises with frequent rest/ learn diaphragmatic breathing technique,
- Eat nutritious/healthy food/ try to have sound sleep ( Use Yoganidra)
- Take regular treatment with periodic check ups.
I hope, the answer has provided sufficient information & help to you. Any follow up query is welcome.
Please grade the answer before you close your query.
Thanks.



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