Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Thumb tremor

Forum: Neurology Forum
Topic: Movement

Hello-
What can you tell me could be the possible reason for an "intention tremor" of the thumb? I've had a UCL ligament repair, 2 joint releases, and 2 carpal tunnel surgeries in past 3 1/2 years. Through all of the my thumb continues to "shake" very much while attempting to use it and has a weak pinch. Is it nerves? Muscles? My surgeons have not been able to tell me exactly what's causing this? Who can be of assistance? Thank you.

Dear Susan,

An "intention tremor" is one that describes gross incoordination with larger amplitude movements. It is suggestive of cerebellar or brainstem involvement. From what you describe, I do not think this is what you have. The multiple surgeries that you describe, especially, the carpal tunnel surgeries imply that you must have moderate to severe impairment of the median nerve. This nerve supplies the oppones pollicus muscle (responsible for some Pinching movements) in addition to other muscles in the hand. The "tremor" that is illicited from movements such as "pinching" may be seconday to fatigue in these weaker muscles. A repeat EMG/NCS may be help in quantifying the degree of injury. Physical therapy and occupational therapy may also help. Discuss these options with you doctor . If you are interested in getting an evaluation at CCF, call 1-800-CCF-CARE. Good Luck.

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