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Forum Name: Neurology Topics

Question: tremor in hand and some cognitive changes


 zendralmt - Fri Aug 29, 2008 8:04 am

I am 32 years old and I have practiced massage therapy for almost 11 years. I am mom to four children. I have had a tremor in my right hand for maybe 3 years. I think it has increased in the past year. It is constant, but tends to worsen at times. It is most noticible when I reach out to pick somthing up, or am holding a cup, also when I am giving a massage(applying pressure). Somtimes my legs shake, mostly my right leg and somtimes it feels as if my back or entire torso tremors(I don't think this is detectable to others). I have been very fatigued, and I have had some difficulty with my speaking ability more recently. I have always been an articulate person and suddenly I am struggling to structure my sentences properly, I somtimes have difficulty finding words or finishing my sentences. It is not terribly obvious to others. My hair is falling out. My arms and legs fall asleep frequently. Sometimes my tounge feels tingling or numb in spots, this comes and goes. I occasionally have painful spots on my scalp, it feels like a bruise that doesn't go away for many months. I also have had pain with no injury, it feels like a very bad sunburn or abrasion, it appears suddenly and then goes away a few days later. It occurs on my legs, or arms, and sometimes my neck, back or face. It started happening in 1999. I have had severe migraine headaches that started about seven years ago, but not so bad lately.
My previous diagnosis include chronic bladder infections(since childhood), asthma(2000), and herpes(1998). I have had a diagnosis of thyroid nodules in the past as well, along with post partum thyroiditis, so initially I assumed somthing was wrong in that department. My family doc did a TSH and free T-4 panel, He said it was normal. TSH was 1.06 and I can't recall T-4 level. Anyhow he refered me to a neurologist, I saw him this past week and he said that he wants to rule out MS and made no mention of any other possibility. I have no health insurance at the moment. I have to wait untill December(open enrollment) to have an MRI. I am really worried about the MS suggestion.Could this be possible?
 John Kenyon, CNA - Sat Sep 20, 2008 9:06 pm

User avatar Hello -

MS is one possible cause of your symptoms, as it can be insidious or sudden in onset. The good news is that while there is no cure, there are generally ways of managing it, often with very good results. While it may flare up at times it can also go into remission. It is an odd disease, but not the worst thing, neurologically speaking, one could have.

There are other possibilities, but the MRI to rule out MS is the proper first step. If that comes out negative for plaques on the brain and/or spinal chord, then other, more obscure problems have to be considered, such as Parkinsonism, ALS, and perhaps idiopathic peripheral neuropathy (IPN). This latter, while not usually as big a problem as the others, can be difficult to treat and requires some patience and care if balance is affected. You could even be suffering from myasthenia gravis (MG), which is another demyelinating disease.

The symptoms and onset most resemble (in my experience, anyway) MS, but that's no diagnosis, just an observation. The sooner you can know precisely what's going on, the sooner it can be addressed and managed. December is a long way off, but a simple MRI can be pretty expensive. So long as your symptoms don't worsen dramatically you should be OK to wait, but it would be best if you could get the jump on this. It would also undoubtedly help to relieve the stress of wondering what comes next.

Best of luck to you. Please stay in touch and follow up with us as necessary.

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