Fasciculations, Tremors, Intention... Oh My!

[madmelissa]

Sorry about the title - my attempt to inject humor into something that is really bugging me!

My GP has called the tremor that I get in the pinky and ring fingers of my right hand "fasciculations" and I was hoping someone here might be able to help clarify something for me.

These tremors started at the same time my drop foot came on, a little over a year ago. It pretty much goes away when I am not flaring up, but each flare brings it on stronger, and this time around it is including my middle finger, and occasionally my index finger and thumb. The tremor is NOT there when my hand is relaxed (for example, hanging at my side or with the fingers curled). However when I stretch my hand out/straighten my fingers, they start jumping around wildly. It is like they have a mind of there own. They do not necessarily move together - each finger moves at random on it's own.

They don't do this when I'm eating (I'm not stabbing myself in the face with a fork). I think I could do the "touch your nose, touch the neuro's finger" test just fine, though I suppose if it starts to affect my index finger more it might be an issue. I do notice it when I type at times - particularly when reaching the number keys on the top row, or hitting the slash key. Basically the keys I have to reach for.

So, is this a type of intention tremor? Does anyone else here have this type of tremor or fasciculation?

Thanks,
Melissa

[Sidesteps]

We could be twins!!!

Like JJ, I have more than one as well --- I have had hypoglycemia tremor's in my past. Those tend to be very specific and occur when my sugar levels are too low. I also get similar tremor's when I've had too much caffeine.  

My initial symptoms began with myoclonus (the hypic jerks) which increased at a stready rate even during the day and fasciculations which also became progressive. The closer I became to my flare the worse all these became. When I mentioned this to my doctor at a physical last summer and she told me not to be concerned but it was so obvious something was not right.

Both these symptoms increased to the point that it became "tic like" and the twitching ocurred ALL OVER my body. I know now that some of it was twitching, myclonus, parathesia and tremor's. They are now like my warning like. LOL!

The tremor's are lingering "damage" and seem to get worse when I'm struggling. These primarily affect my left hand the most - like last Friday I had a fasciculation that twitched my thumb for 5 hours. The tremor that concerns me is the ones that are like a vibration or when there is difficulty maintaining a target (holding something or typing like you.) I think my tremor's affect my speech as well. My voice will get hoarse and I sound like a boy going through puberty with cracking with fluctuations. Kinda interesting. I'm now getting them in my jaw at times too. Weirdness!

[supermum_ms]

Table 1. Classification of Tremor by Clinical Phenomenology

Rest tremor Present when skeletal muscles are not voluntarily activated and the relevant body part is fully supported against gravity. Associated with PD, secondary parkinsonism, hereditary chin quivering, and severe ET. Often suppressed with voluntary muscle contraction.

Action tremor Occurs upon any voluntary muscle contraction and may include any combination of postural, kinetic, task- or position-specific, or isometric tremor.

Postural tremor An action tremor that is present while voluntarily maintaining a position against gravity. Associated with ET, primary orthostatic tremor, physiologic and enhanced
physiological tremors, drug-induced and toxic tremors, neuropathic tremor, cerebellar head tremor (titubation), and dystonic tremor.

Kinetic tremor An action tremor that occurs with any form of voluntary movement including visually- or nonvisually-guided actions, such as speaking, pouring water into a cup, or finger-to-nose testing. Associated with ET, classic cerebellar tremor (e.g., seen in multiple sclerosis, infarction), dystonic tremor, drug-induced or toxic tremors, and midbrain lesions. Includes dynamic or terminal tremor, which occurs with target-directed movements, and simple kinetic tremor, which is present with nontarget-directed actions.

Task- or position-specific tremor A kinetic tremor that occurs during performance of highly specialized, complex movements, such as writing, speaking, or smiling. Primary writing tremor and isolated voice tremor are included.

Isometric tremor A kinetic tremor present during voluntary muscle contraction against a rigid stationary object, such as making a fist or flexing the wrist against a horizontal, flat surface.

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The best information on movement issues are found here http://wemove.org/et/ Its often recommended to have a read, Quix put me on to it when i was trying to work out my tremors, i seem to have more than one lol

Cheers........JJ

[drsdonthelp]

Hi Melissa,
I too have a tremor in my left hand, it happens mostly with movement, pointing my finger, reaching for an object, trying to put makeup on , and getting ready to write something. I notice it ease up when I am more relaxed, but if I make a bed or sweep the floor, and as soon as I am done, my tremor becomes more noticeable. It doesn't shake at all when I have my hand down on my lap or in a resting manner.

My tremor started in December and is still going on today. It has slowed down some since the beginning (very big shaking movement) I could not touch my target for the life of me.
I don't know if this is considered a flare or not, or is this tremor that I have now since it has slowed down a bit going to be the lasting effect.

As far as twitching.... I have had a thumb twitch in my left hand for three months. It would go on all day on and off. After the twitch left my thumb, it then started up in the shoulder blade on my back on the left side as well. Occasionally I get the thumb twitch, but not as often as it was occurring.

Hugs,
Pam