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Forum Name: Neurology Topics

Question: Trembling Please Help


 bamajilly - Wed Jun 03, 2009 12:40 am

I have been suffering from an almost constant slight trembling for a while.
It began when I went to the gym one day. I am not an active person and was trying to better my health. When got back from gym felt fine. When went to lay down for bed suddenly my teeth became extremely sensitive. Then I had a weird sensation in my hands and feet. When they touched something it made my skin crawl like scratching a chalk board. The sensations came and went for several weeks which caused a lot of anxiety. I began taking Xanax 0.25 occassionally. I noticed my hands began trembling slightly in a three rythm. Then realized it was my whole body. Now I am really anxious about the trembling. Also taking promethazine frequently for stomach from anxiety.
I have since had my teeth removed to improve my health. Assumed the sensitivity was from something I did to my back when exercising. The crawling comes back if I sit or stand for long periods.
The trembling continues. Sometimes worse then others.
I have had an MRI without contrast and bloodwork. Results negative. The physician thinks it is from anxiety.
Requested to see Neurologist for own peace of mind. Thought the other test being negative would ease my fears but still anxious. Do not know if anxiety making me tremble or trembling making me anxious.
I have become almost totally sedentary because I am so concerned about it. Am trying to be more active. Have been out of the house only few times in 3 months. Do not want it to be pushed off to anxiety if other possibilities.
What are the possible causes of this? What should I ask my neurologist? Is it possible it is anxiety?
 John Kenyon, CNA - Tue Jun 09, 2009 12:14 am

User avatar Hi there --

FIrst, while your symptoms could possibly be caused by anxiety, what you describe doesn't really sound typical for generalized anxiety disorder (GAD). You may in fact have GAD or your feelings of anxiety may be due to the symptoms you've been suffering. Your decision to request a neurological consult is a very wise one, as it seems far more likely you started with some new-onset neurological problem and the anxiety is either co-existing with it or caused by it. Again, it is possible this could all be caused by anxiety but it reallly doesn't seem to fit the usual picture.

It would be impossible and unwise to try and guess what's causing this, since there are a fairly large number potential causes. As far as your conversation with the neurologist I don't think it's so much a matter of what questions to ask as how to present your case. You'll need to be as calm and centered as you can be in order to remember all the things you want to describe as part of what has been happening. The neurologist will want to do a history and physical which may, in fact, help expose or at least give clues to possible physical causes. While you may feel anxious most competent neurologists can pick up on the difference very quickly. I certainly hope you draw a good doctor who's interested in sorting out the many possibilities and narrowing the field so as to make a good differential diagnosis and the more information you can give during the initial consult, the better.

This is a deliberately vague answer because, as I said earlier, it is impossible, due to the number of potential causes, to try and guess at this. Your neurologist may recognize something face-to-face, right off the bat, or may want to do some specialized neuro testing. You're pointed in the right direction. Just go with it, be confident and assertive and insist on being heard. That's about it. The doctor will ask the questions. Answer carefully. I hope this is helpful and good luck to you with this. Please follow up with us here as needed.

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