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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Tremors In The Hands And Legs?

My mother had uretheral stints put for the 2nd time a few weeks ago, she has developed some tremors in her hands, arms and legs. She appears somewhat lethargic, urinates often and with sometimes has incontinence. Could she have a urinary tract infection without necessary having fever? She is under the care of a urologist who is difficult to reach. She was admitted to the hospital back in February due to high blood pressure out of control which she was treated for for years with HBP medicine. They found she has an obstruction near the ureters, hence the reason for the stints. The obstruction they believe is a pelvic mass. Cannot do a biopsy with contrast as that would jeopardize her kidneys. She is 79 years old and does not want all the possible cancer treatments if that is what it is. The goal is to keep her off dialysis right now. She was walking and maintaining a quality of life after the first stint procedure. She is 79, however she was very active and maintained a very healthy lifestyle all her life. She had a double hip replacement in 2012. At that time, her blood tests were very normal. Until January 2017, her blood tests were perfect. She was called as her creatinine was 4.5. It is now 1.40. She has rebounded since the kidney failure. Could hip replacements cause any of this?
Mon, 17 Sep 2018
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Diabetologist 's  Response
Hello,



I think you should meet a neurologist as soon as possible.

The tremors at this age are most commonly seen with Parkinsonism. Now Parkinsonism is known to have these symptoms of tremors (as common knowledge). The lethargy that you have mentioned in the early part of the message could be a part of the same syndrome, as walking or moving slowly may be a part of Parkinsonism as well (called bradykinesia).However they are also known to have bladder related problems- namely incontinence.



Now she was found to have a renal mass and was in azotemia (raised creatinine). So I cannot say that all of the symptom of incontinence is due to the Parkinsonism. But a part of the symptoms being due to Parkinsonism is possible. And medications for Parkinsonism may help her with the Parkinsonism features. Hip replacement is unlikely to cause these symptoms.



Hope I have answered your query. Let me know if I can assist you further.

Regards,

Dr. Saumya Mittal, Diabetologist
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What Causes Tremors In The Hands And Legs?

Hello, I think you should meet a neurologist as soon as possible. The tremors at this age are most commonly seen with Parkinsonism. Now Parkinsonism is known to have these symptoms of tremors (as common knowledge). The lethargy that you have mentioned in the early part of the message could be a part of the same syndrome, as walking or moving slowly may be a part of Parkinsonism as well (called bradykinesia).However they are also known to have bladder related problems- namely incontinence. Now she was found to have a renal mass and was in azotemia (raised creatinine). So I cannot say that all of the symptom of incontinence is due to the Parkinsonism. But a part of the symptoms being due to Parkinsonism is possible. And medications for Parkinsonism may help her with the Parkinsonism features. Hip replacement is unlikely to cause these symptoms. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Saumya Mittal, Diabetologist