What causes severe hand tremors post simple activity in an elderly woman?
Essential tremor/anxiety/thyroid disorder/Drugs/Alcohol
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I am Dr.Ajay Panwar,a neurologist,here to answer your query.
If you would have presented to me as an outpatient,I would have asked you the following details in order to answer this query well-
1)Since when he is having tremors?
2)Did the tremors start in both hands symmetrically?
3)Is family history positive for tremors?
4)Are tremors absent at rest?
5)Is there a positive history of frequent alcohol intake/anxiety/thyroid disorder?
6)Are you on any drugs?If yes,please list them.
7)Is there a history of rigidity or slowness?
I shall be glad to have you in follow-up with details so that I can answer this well.
Thanks very much for the substantive feedback. I will speak with my spouse to address your questions and get back to you soon. Thanks very much!
Thanks for being in follow-up.
Pleasure.I shall be waiting for your further response.
Hi! I have spoken to my wife and have the following answer to your questions:
1) Since when is she having tremors...Answer: about 1 year
2) Did the tremors start with both hands...Answer: First the right hand, then left; however, it now seems to correlate with the weight of the item being held; also, when she is tired, the trembling is worse; when she is not tired, there is no tremors;
3) Is the family history positive for tremors..Answer: Her father, deceased at age 88, developed tremors when he was in his 70's; he was not diagnosed with Parkinsons;
4) Are tremors absent at rest; Answer: Correct, no tremors at rest
5) Is there a positive history of frequent alcohol intake / anxiety / thyroid disorder...Answer: there seems to be a correlation with anxiety only (my wife has an alcoholic beverage very infrequently; she has not been diagnosed with any thyroid condition;
6) Is she taking any drugs? Answer - No, just some vitamins; e.g, B6/12 sometimes or Folic Acid;
7) Is there a history of rigidity or slowness? Answer: No.
Thanks for your consideration!
Thanks for being in follow-up and providing further details.
Considering the clinical details,the most likely cause of these tremors in anxiety.These appear to be exaggerated physiological tremors,at times.However,Essential tremors is another possibility which is substantiated by positive family history.
I suggest that she should start on clonazepam for now and response should be observed.If this medicine improves the tremors,then they are likely due to anxiety.If there is no response on clonazepam,then propranolol should be started.If tremors respond to propranolol,then probably they are Essential tremors.
PLEASE TAKE MEDICINES UNDER A PHYSICIAN'S GUIDANCE ONLY.
Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.
Thanks very much for the very helpful and lucid response. I will provide your response to my spouse and will also make an appointment with her doctor, along with your advice. I/we appreciate your service very much! I will be closing the account for now and righting a very positive review. Thanks again!
Thanks for being in follow-up and appreciating me.
You are most welcome to connect with me,anytime you have a query in future.
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