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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes The Shakes In The Arms?

My wife had c-4, c-5 and c-6 cut back so that they would no longer be pressing on the spinal nerve. A fusion was done, and she was healing nicely. One week later, she began to uncontrollably shake primarily in her right arm and hand and somewhat in her left arm and hand. Could this be from inflammation from the surgery; a pinched nerve from not sleeping correctly? We are scheduled to see a Board-Certified Neurologist on Monday. We are just scared. There is no pain involved, just involuntary shaking, and the shaking stops when she lies down at a 40-45 degree angly.
Fri, 27 Nov 2015
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Neurologist, Surgical 's  Response
Hello. Thanks for asking from HCM.


I can understand your concern. Based on your wife's surgical detail, most probably she might had disc compression at C4-5 and C5-6 along with cord compression. I could not make out whether surgery was done via front aspect or back of neck. You can provide more details in another question. Any way, if there was compression of cord which got relieved after surgery, she had shown some improvement.

Now that she had again deteriorated after one week of surgery, it might be due to the edema of surrounding tissue, failure of fusion construct, late bleeding and blood clot, granulation tissue after inflammation or disc at another level causing compression of cord. These shakes are most probably due to hypertonia of muscles, less chances are of tremors. It can be confirmed by clinical examination and MRI of cervical spine. Exact pathology and cause will be confirmed after it and based on it, further plan of management like surgical decompression of spine or medicines like baclofen to relieve tone will be decided.

You need to consult neurologist. He will examine your wife and advise MRI. Meanwhile, your wife should avoid neck movement as much as possible, use cervical collar if you have it at home, avoid neck pillow, any kind of weight lifting, avoid any kind of jerky movements, check for sensations of all extremities for any loss. Absence of pain is a good sign as it means no focal nerve compression.


Thanks. Hope it will help you. Take care.
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What Causes The Shakes In The Arms?

Hello. Thanks for asking from HCM. I can understand your concern. Based on your wife s surgical detail, most probably she might had disc compression at C4-5 and C5-6 along with cord compression. I could not make out whether surgery was done via front aspect or back of neck. You can provide more details in another question. Any way, if there was compression of cord which got relieved after surgery, she had shown some improvement. Now that she had again deteriorated after one week of surgery, it might be due to the edema of surrounding tissue, failure of fusion construct, late bleeding and blood clot, granulation tissue after inflammation or disc at another level causing compression of cord. These shakes are most probably due to hypertonia of muscles, less chances are of tremors. It can be confirmed by clinical examination and MRI of cervical spine. Exact pathology and cause will be confirmed after it and based on it, further plan of management like surgical decompression of spine or medicines like baclofen to relieve tone will be decided. You need to consult neurologist. He will examine your wife and advise MRI. Meanwhile, your wife should avoid neck movement as much as possible, use cervical collar if you have it at home, avoid neck pillow, any kind of weight lifting, avoid any kind of jerky movements, check for sensations of all extremities for any loss. Absence of pain is a good sign as it means no focal nerve compression. Thanks. Hope it will help you. Take care.