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What Causes Involuntary Shaking Of Hands?

Posted on Fri, 28 Feb 2014

Question: Hi .. I am writing about my husband (who is too busy he says to go and see a doctor). He has two issues that concern me. The first issue is that his hands constantly shake. He says he has always been like this and doesn't think it is an issue. The second issue is a skin condition that -- to me -- looks like it might be psoriasis. I wanted to know if I could take a picture of it and get confirmation if it is indeed psoriasis. It looks like pictures that I have searched on the web. It is large, red, highly itchy, and scaly.

Answered by Dr. Dr.Albana Sejdini (2 hours later)

Brief Answer: Please provide the requested data of your husband! Detailed Answer: Hi, Thanks for your query. I have read the medical history of your husband, and I kindly ask to send me the pictures of the skin problems of your husband. That could help me assist him further! With regards to shaking hands, I'd like to know if: - the hands are shaking while he is resting? - or when he is doing something? (trying to reach something for example)? - is the shaking all the time or occasionally (e.g. getting emotionally involved or stressed, etc.) Looking forward to have the requested data in! Dr.Albana

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

Follow up: Dr. Dr.Albana Sejdini (10 minutes later)

Dear Dr. Albana, Thank you for your reply. For the skin condition, I will have to take a picture when he gets home later this evening. As for the shaking hands, they shake a little all the time. It doesn't have to do with stress/work/activity. If he holds his arms out his hands constantly tremble. He cannot stop them shaking. I am not sure about when he sleeps/rests. I will have to look.

Answered by Dr. Dr.Albana Sejdini (23 minutes later)

Brief Answer: Looking forward to have the requested data.... Detailed Answer: Hi back, Thank you for following up. Can you please also specify if he is consuming alcohol and in what amount? Is he taking any medicine on regular basis? Is anyone from his family having history of brain/other similar problems? Is the shaking present while he tries to catch something (a glass of water for example)? Looking forward to have the pictures and other requested data! Thank you! Dr.Albana

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

Follow up: Dr. Dr.Albana Sejdini (21 minutes later)

Dear Dr. Albana, He virtually never consumes alcohol. He doesn't take any medication on a regular basis. His mother had diabetes but there is no known condition of shaking hands in the family. His hands also shake when holding items but it hasn't affected his ability to do tasks as the shaking is constant (like trembling).

Answered by Dr. Dr.Albana Sejdini (26 minutes later)

Brief Answer: Advised further neurological tests.... Detailed Answer: Hi again, If this is his case, then, a further appointment with neurologist should be scheduled to get him neurologically checked (check the function of nerves and muscles) and to run further tests: - measuring the levels of thyroid hormones - check his blood sugar/pressure - complete blood profile - urine analysis - EEG The neurologist might also ask to run Ct-scan of head or MRI depending on the neurological examination. If he is dealing with chemicals at his work, then, should check the levels of such chemicals in his blood and urine. Meanwhile, until he sees a neurologist, I'd advise to: - avoid using caffeine rich foods/drinks including energetic drinks - try stress-relieving exercises/breathing - get him clothes that are easily to handle (no buttons for example or button hooks). Looking forward to have the pictures of the skin problems of your husband when he gets back home! Thank you! Dr.Albana

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

Follow up: Dr. Dr.Albana Sejdini (19 hours later)

Dear Dr. Albana, Thank you for your response. I want to ask about uploading a picture. Will this picture be available for the general public to see or will it only be seen by you? Privacy is a concern and I do not want pictures floating about on the net for all to see. I understand that searchers can see messages with identification removed but I want to understand how Healthcare Magic handles pictures uploaded. Also, do I need to start a new question for this as there is no upload feature in the reply messages? The upload feature only showed up when I first asked my questions.

Answered by Dr. Dr.Albana Sejdini (24 minutes later)

Brief Answer: XXXXXXX highly keeep the privacy of photos... Detailed Answer: Hi my dear, The photos you will upload will be visibly only for me to assist you. There are many other patients uploading photos to me and my colleagues, which has helped us assisting online patients accordingly. Please bare in mind that privacy is included in "terms and conditions" of this site. No picture uploaded is publicly seen at XXXXXXX unlike to other "Ask the doctor" sites on net. I can assure you for that! If you find it difficult to find "upload" at the right below button, you can send the pictures at YYYY@YYYY , with subject line "Attention to Dr.Albana Sejdini". The photo will be directed to me accordingly. Looking forward to have the photos in to assist you further! Dr.Albana

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr.Albana Sejdini (1 hour later)

Thank you Dr. Albana. I uploaded the picture of the area affected for your review in the "upload new reports" area.

Answered by Dr. Dr.Albana Sejdini (2 hours later)

Brief Answer: Advised microscope exam. of skin scrappings... Detailed Answer: Hi back my dear, Thank you for following up. I have seen the photos of your husband's skin problem. Indeed, it seems to be an inverted psoriasis. However, I do usually ask my patients to do a microscopical examination of the skin scrapings of the affected area (with KOH 10%) to rule out fungal infection of the skin. At your husband's case, I'd suggest to: - should cut the hair of the affected area for better treatment results - keep the area well cleaned (using hypoallergic soaps) and well dried - after cleaning and drying, apply otc hydrocortisone + miconazole cream at night and vit.D cream (calcipotriene) in the morning - ask him to wear cotton pants If he will not get better within a week, should consult with dermatologist as he might need oral prescription therapy or phototherapy. Please bare in mind that psoriasis is an auto-immune disease and often associated with hardening of arteries and cardio-vascular events. As you husband is having frequent shaking of hands, I'd suggest to run further tests to evaluate if the arteries of his brain are being damaged and causing shaking as mentioned earlier. Hope it was of help! Dr.Albana

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

Follow up: Dr. Dr.Albana Sejdini (1 hour later)

Dear Dr. Albana, You have been a great help so far and I checked to see if I could get those medications. The hydrocortisone combination is not available in the US and the Vitamin D cream must be obtained with a prescription. In the meantime, would it be ok to use salicylic acid cream to ease the problem until I can find a local doctor and get him in to see the doctor?

Answered by Dr. Dr.Albana Sejdini (44 minutes later)

Brief Answer: Please take separate cream&then,combine... Detailed Answer: Hi my dear, You can use salicylic acid cream; however, I did not mention it as I'm afraid it could cause irritation to your husband's skin. If not a hydrocortisone combination, you can ask for miconazole or clotrimazole cream at your local store and hydrocortisone cream separately. You can mix 1 part of anti-fungal cream with 1/4 of that part of hydrocortisone cream. If cannot obtain vit.D cream, can ask for zinc oxide cream (I think you can get it by your local store). This is all you can do until you see the dermatologist and neurologist. Hope it was of help! Dr.Albana

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