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Tremor or Clonus?
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Tremor or Clonus?

I've tried to google this, but haven't found an answer.

For the past few days, I've noticed some shaking in my hands. Yesterday, while using the computer when moving the mouse, my right hand would start to shake. My wrist was resting on the mouse pad. Later, I was lying down reading, with my left elbow resting on the couch (more or less at a 45 degree angle) and that hand would start shaking. If I took the pressure off the elbow, my hand would stop shaking, but as soon as pressure was put back on the elbow, my hand would begin to shake again.

It's my understanding that the ulnar and median nerves run through both the wrist and the elbow. Can pressure on one of these nerves produce shaking? If so, would that be considered a tremor or clonus?

As for Google, does anyone have a favorite search engine for more refined searches when it comes to medicine/health?
6 Comments Post a Comment
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1475492_tn?1332887767
That is a tremor. I have it too- like right now while flared.

I can also get tic like movements in my fingers or muscles and that are myoclonus. Myoclonus tends to be like a jerk like a hiccup.

Tremors are more like a shake which can be subtle or larger.
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1045086_tn?1332130022
Someone was asking a similar question not too long ago.  I managed to find what I wrote then and will copy it here.  I do agree that you are probably describing a tremor BUT these things can be difficult to label even when the docs observe them directly.  Guesses based on verbal or written descriptions have a high degree of inaccuracy.

I would think pressure on a nerve (compression) would more likely cause pain or changes in sensation than a motor symptom like tremor.  Is there any possibility this could have been related to muscle fatigue?  This happens when sustained tension is required within a muscle group (watch the Olympic weight lifters as they start to shake at the end of a lift!).  It happens normally but the same thing can occur more quickly (after smaller exertions) if there is a nerve conduction and/or muscle pathology.

Otherwise, this could fit the description of a resting tremor (as opposed to an intention tremor).  There are differences in what causes each.  This would probably need to happen on a regular basis for it to be important.

Fasciculations are a possibility too but I’m not convinced it fits this.  I describe them in my copy/paste below.

Grrrrr, it's lousy to be reminded we can't always remain in control of our bodies.

Here's the rest - my reproduced answer:

Myoclonus refers to sudden, involuntary jerking.  It occurs in healthy people (in events like hiccups or 'sleep startles' which occur as you fall asleep) but is also produced by many different diseases and disorders (epilepsy, brain injury, infections, spinal cord injury, neuro diseases).  Myoclonus is initiated in the CNS, often in the brain stem.  It can be regular and rhythmic, singular or occur in random patterns.

Clonus is a rhythmic contraction that results from sudden or sustained stretching.  It originates in the brain or upper motor neurons of the spinal cord and is a hallmark sign of extreme hyperreflexia.  Clonus is really an increase in deep tendon reflexes and indicates a loss in the reflex arc's ability to inhibit muscle contraction.

Clonus can be triggered by any movement that causes a quick or sustained stretch of a tendon.  Neuros attempt to purposely trigger this sign of neurologic damage by holding your foot and then quickly pushing your toes toward your shin, by quickly flexing your wrist or with quick, forceful downward pressure applied to your knee.  Here's a video showing ankle clonus during a neuro exam.
http://www.youtube.com/watch?v=XCWSCSad0Fo&feature=related

Fasciculations are muscle twitches or contractions in small groups of muscle fibers.  Sometimes they go un-noticed but often they are visible under the skin.  They can be common and normal or signs of a nervous system disorder.  Benign fasciculations often occur in the eyelids, thumbs and legs.  They come and go, often increasing with exposure to caffeine, stress or fatigue and decreasing during activity or stretching exercises.  They rarely last longer than several days at a time unless they are caused by a disease process.

Muscle problems that originate in the CNS don’t show up as abnormalities on an EMG.  Not all PwMS are troubled by undesired muscle movements.  When they are, I think the problem is likely to appear and disappear with flare activity more than get progressively worse.

It can be difficult to distinguish these different types of involuntary muscle movement from each other and even harder to guess their cause.  Your best bet is to give your neuro a good description.  Get a quick video if you can of anything that doesn’t reproduce easily (like ‘office shy’ symptoms).  Of course it’s always a good idea to watch for and report any patterns in your symptoms or anything you suspect might be triggering them.
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987762_tn?1331031553
My world is dominated by my bodies contant movements, even my head bobbles in a no no no rythm if its not supported lol everything shakes rattles and rolls in this gal.

If i'm just talking about the movements only in my hand, when its good its now a constant fine rythmic butterfly wing fluttering, tiny visible shimmering but if I hold something so my hand is curled in a soft grasp eg pen, you can more easily see it because it now has more of a rumble to it, and a little jerk added to its rythm. If I hold something with any weight eg a cup the jerk is more pronounced because you see the cup wiggling about then a quick dip and involuntary correction (jerk). This is all exaserbated if i am standing because i'm dealing with the kinetic (body against gravity) tremor so the rythm is more noticable because its rumbling.

To me clonus and myoclonus are more startling, jerks or big bouncy movements, my left leg clonus is rythmic but its very bouncy. If i have even a slight bend in my anckle, the leg involuntarily jerks or bounces up and down, the bounce gets bigger and stronger the longer i keep the bend. Its why i walk like a string puppet, the anckle and foot need to bend with the action of walking. in both legs now but the left is still the least reliable of the two. I'm constantly trying to fight it, and the unlocking on my knee, even my hip will pop out too, strange much lol

Iol i didn't actually realise the full body jerks i did were not normal and myoclonus, i assumed they were normal sleep starts because i was in bed lol What makes it abnormal is that i am completely awake, i havent just fallen asleep or even trying to fall asleep when I experience them. They happen when i'm laying down or when my body is fully supported, i'm usually in bed reading or meditating. I sometimes recognise the change or warning a second before it hits, odd feeling and its almost like every muscle and or tendon retacts down hard then lets go again, I jerk hard though it doesn't hurt its a bit of a shock.  

Interestingly when i support any body part the tremor is at its most calm, where you experienced the tremor with resting on your elbow and stopping the tremor when the pressure was released, for me its basically the opposite, with the only response i get is a very slight swaying. To be honest i'm not even sure i'd class what you've said as particularly abnormal because from my knowledge and experience with tremors, the lack of support is what makes it show its self. I suppose it could fit within the description of resting tremor more often seen in PD but i thought you'd still have the twisting (like turning a door knob) tremor so i'm not entirely sure on this one.

Have a look at the web site 'wemove' which explains all movement and quite informative overall.

Cheers...........JJ

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198419_tn?1360245956
Audrey - Did this help?
Mary - Can I make this a health page? Excellent info!
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1045086_tn?1332130022
It would probably make a good Health Page.  We always have lots of questions about the weird ways parts of our bodies move.  I was going to add some info about tremors but hadn't gotten around to it.  (Where does one find a round tuit anyway?)

Go for it Shell - and thank you so very much!  I'd be glad to still contribute something about tremors.

Like JJ, I would include a recommendation to reference the WeMove site for good explanations of different types of movement.
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1260255_tn?1288658164
Yes, its good info.

Probably something to ask at the next neuro exam, because it has been consistently reproducible over several days.
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