Stress? Faciculations? Essential Tremor?

I am a 29 year old male in relatively good health.  Aside from a tendancy to high cholesterol levels, there is no history of illness of any sort in my family.  Several months ago I had an anxiety attack and thought that I had some sort of heart problem.  I had a pounding heart and my hands trembled for about a week.  I had several heart tests including a holter test, as well as blood and urine tests and everything came back negative.  The doctor said that it was likely stress.  I did indeed have stress from work, and subsequently from my symptoms.  After being told there was nothing wrong, the heart symptoms faded away, but the shaking remained.  It is present at all times. The source of stress from my job is gone now, and the only real source of stress I have now is the shaking in my hands (I worry about what it could be...).  I will try to describe it as best I can.  

The strength of the shaking at it's worst is strong enough to make a regular sized paperback book visibly tremble when I hold it in one hand, but not bad enough that I can't read it.  These days, I can usually hold a piece of paper with no visible shaking.

The trembling does not interfere with my regular activities in any way.  I have no loss of manual dexterity at all.  

It becomes worse if I am worried, if I drink a lot of caffeine (I used to be able to drink buckets of coffee when I was in university with no shaking...), or don't get enough sleep.

It disappears if I drink alcohol.

If put my hands in front of me with my palms facing forward and slowly move them so that my palms face downward, my hands shudder.  Doing the same motion with my feet produces the same effect.

When it is bad, I can feel a similar vibration in muscles in my legs or neck, but there is no visible shaking/trembling.  This feeling (in places other than my hands ) never lasts very long.

I have recently tried to adjust my sleep schedule so that I get 8 hours every night, and (as a result?) the shaking has almost gone, and the shuddering associated with those specific wrist and ankle positions is greatly reduced but not gone.  I am concerned/puzzled about several things...Symptoms disappearing with alcohol consumption is consistant with essential tremor, but the degree of shaking seems so minor as not really qualify as a 'tremor' but a vaciculation (spelling?).  Furthermore, as I understand it, essential tremor rarely affects the lower body, but I have the same sort of shuddering in my lower legs as in my hands.   If indeed these are vaciculations, should I be worried about Lou Gehrig's disease?  I know that there is weakness in the shoulders and legs associated with this, and I think I have become too sensitive about this. The slightest twinge in my legs  makes me worry.  Honestly, if I hadn't read anything about Lou Gehrig's disease, none of the 'twinges' in my legs would have concerned me in the least, and I have noticed no change in actual strength of my legs or arms.  Recently, more than my shaking, the amount of time I spend worrying about it is becoming cause for concern.  I am going to my hospital next month to the nerve specialist to get these things checked out, but I am a Canadian living in Japan.  My Japanese is not bad, but it isn't really up to a conversation with a doctor full of specialize Japanese neuro-vocabulary!  
I had none of these symptoms until my anxiety attack a few months back.  When I noticed the symptoms, I began checking health sites like this, and while they have certainly been a great help and I am very grateful for this service, I think that at least, in my case, "a wealth of information" is a contradiction in terms.  The more I read (about things like Lou Gehrig's disease, Parkinson's disease, etc.), the more alarmed I become, and the more alarmed I become, them worse I shake.  I am concerned that I simply giving my active imagination fuel.  Could the shaking be caused by stress?  Could it be pychosomatic?  I am most worried about Lou Gehrig's disease.  Having read all this (sorry I wrote so much), what do you think?  Is what I have described here something that I should be really worried about?  I have read so much at this and other sites, but I think it isn't much help without a medical professional's input to give me some sense of perspective.  Anything you can tell me would be a great help.  Sorry for the epic sized question!

[Roger Gould, M.D.]

I agree with your doctor and with you. This is most likely stress and it is increased because you have been focusing on it. I would take comfort in the fact that you can make it disappear with sleep and alchohol. That makes it more likely that it is stress and anxiety. You might try a short term trial of xanax to see if that helps break the cycle of preoccupation. Otherwise meditation might help, or if you are ready, a consultation with a therapist to see what you can do about the cause of the stress.

Of course, if the symptoms change dramatically, you should consult a neurologist to give you comfort that it is not something more serious.