What Do Sudden Tremors Indicate?

Posted on Tue, 24 Oct 2017

Question: My wife woke this morning and cannot keep from shaking.

Answered by Dr. Ishu Bishnoi (1 hour later)

Brief Answer:
Need more information

Detailed Answer:
Hi Cxxxxxxy, thanks for asking from HCM.

You are worried about your wife. I can understand that. But I need more information about her shaking symptom

- Is she a known case of seizure disorder?

- Is there any loss of consciousness, tongue bite, frothing from mouth or incontinence?

- Is there any history of anxiety and panic attack?

- What was the duration of shaking? And what part of body was shaking - generalised or some limb?

- Is she a case of diabetes mellitus, neuropathy?

- When you consulted doctor, what did he/she describe or explain to you?

I need these answers, because shaking can occur due to various reasons,like

- Seizure or epilepsy

- Cold tremors

- Anxiety or panic attack

- Myelopathy causing spastic tremors in body

- Neuropathy

The list is long, but above mentioned causes are the most common causes.
I hope you will understand my point. If any doubt, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Ishu Bishnoi (33 minutes later)

She does have history of anxiety and emotional issues. She had a serious discussion with her son last night which upset her vey much and this could have led to her problem this morning. I gave her morning meds to her which include two .5mg alprazolam. When I asked her questions about how she is feeling or what she is thinking about her responses are not making sense. However, I have seen this before. I was concerned that her shaking could be a sign of a stroke.

Answered by Dr. Ishu Bishnoi (8 hours later)

Brief Answer:
Probable cause anxiety panic attack

Detailed Answer:
Hi Cxxxxxxy, welcome back.

Thanks for providing me the history. You mentioned that she is a known case of anxiety and similar kind of episodes had happened in the past. There was a stress generating factor also. All these points are pointing towards "Anxiety/panic attack episode".

You gave her tablet alprazolam 0.5mg. Can you please tell what was her response after having it?

The possibility of stroke is minimal. Because stroke usually presents with a headache or lightheadedness, weakness in limbs, vertigo or loss of consciousness. Seizures or shaking is uncommon in stroke. Still, if there is doubt, it can be easily ruled out by

- MRI brain with DWI/ADC image.

You can send me the images or report, I will guide you further. Hope it will help.
If any doubt, do let me know.
Thanks. Take care.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Ishu Bishnoi (14 minutes later)

She did calm down after her morning meds. She has rested most of the day but any conversation has been in short sentences which made no sense. She needed assistance getting to bathroom and back. This is not new to me. She is now resting, sleeping. I appreciate your concern.

Answered by Dr. Ishu Bishnoi (19 minutes later)

Brief Answer:
Anxiety symptom and management

Detailed Answer:
Hi Cxxxxxxy, welcome back.

Your question has now cleared the doubt. It shows that she was really anxious and had a mental shock. That's why she was not able to converse much and wanted assistance. She might need some time to recover.

To manage such situations, please follow a few points--

- Remain calm and support her.

- Try to talk to her as much as possible. Discuss things. It will relieve her anxiety.

- You can give her tablet Clonazepam (considered better than Alprazolam), Propranolol after prescription.

- If possible, ask her to start meditation and Yoga. It will give her control on her nerves and inner peace.

- A psychologist and psychiatrist consultation will also help her. If the situation is worsening despite these, you can consult one.

I hope it will help and she will recover fast. If you have any kind of doubt or need help, do let me know.

Thanks. Take care.

Above answer was peer-reviewed by : Dr. Arnab Banerjee