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Neurology (Expert Forum)
Re: Right Arm Tremor
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Re: Right Arm Tremor
by CCF MD mdf, Jan 01, 1995 12:00AM
Posted By CCF MD mdf on December 21, 1998 at 08:59:30:
In Reply to: Right Arm Tremor posted by sally on December 20, 1998 at 20:16:13:
Dear Sir, My son who is now 15 has recently developed a tremor in his R arm mostly his hand. He has a history of many orthopedic problems such as Lumbar Schurmans Disease in his back. He has very loose joints. He has previously broken his right elbow and his right wrist but that was 3 years ago. He has also had a broken mandible. The tremor seems worse when he trys to do something with that hand like drinking or writing. He had a ct done 2 years ago when he had a concussion and at that time the report read as this. Promiment subarachnoid fluid collection involving the left cerebellar region. This is likely just a normal varient for this patient. A posterior fossa arachnoid cyst cannot be entirely excluded. Tiny calcification involving the region of the left tentorium. this is not felt to be significant. So is this at all significant he will be having an MRI of his brain with and without contrast this coming Tuesday. These symptoms have been going on for about 3 weeks well actually 4 now. He tends to have a great deal of stiffness and pain in his joints all the time. But because of his Lumbar Schurmans he generally has back pain all the time. He has lived on Ibuprofen for the last five years since his diagnosis of his back problem. Please let me know if you have any ideas or suggestions. I would truely be greatful. It took us a very long time to find someone who could diagnosis his back problems and for that we ended up a Childrens in Chicago. thank you again Sally
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Your description of the tremor was very helpful: you indicated it was not symmetric (right hand mainly) and that it was present not at rest but with action.
Parkinson's disease (very unlikely anyway in a 15 year old) often shows up as a tremor on one side, but it is at REST rather than with ACTION. So that is probably NOT what is going on.
Essential tremor is a benign condition in which your hands shake, particularly when doing something. I've seen it in 15 year olds and in 85 year olds, and everything in between. BUT you would expect it to be symmetric, that is, BOTH hands about the same.
The above two are the most common causes of tremor. However, my suspicion is high that you son's tremor arises from damage to the cerebellum, particularly the output circuitry which connects the right hemisphere (of the cerebellum) to the next station in the brain (the left side of the thalamus). That could mean a lesion in the dentate nucleus, or in the white matter of the midbrain, or perhaps even in the thalamus itself.
If there is a structural cause (stroke, hemorrhage, tumor, vascular malformation, loss of myelin as in MS, etc), then the MRI is the best test to find it. Sometimes cerebellar damage comes from metabolic, biochemical, or genetic causes and the MRI may not really show anything.
I hope and expect your son's doctors are systematically examining him for all possibilities. Good luck to you and him. CCF MD mdf
In Reply to: Right Arm Tremor posted by sally on December 20, 1998 at 20:16:13:
Dear Sir, My son who is now 15 has recently developed a tremor in his R arm mostly his hand. He has a history of many orthopedic problems such as Lumbar Schurmans Disease in his back. He has very loose joints. He has previously broken his right elbow and his right wrist but that was 3 years ago. He has also had a broken mandible. The tremor seems worse when he trys to do something with that hand like drinking or writing. He had a ct done 2 years ago when he had a concussion and at that time the report read as this. Promiment subarachnoid fluid collection involving the left cerebellar region. This is likely just a normal varient for this patient. A posterior fossa arachnoid cyst cannot be entirely excluded. Tiny calcification involving the region of the left tentorium. this is not felt to be significant. So is this at all significant he will be having an MRI of his brain with and without contrast this coming Tuesday. These symptoms have been going on for about 3 weeks well actually 4 now. He tends to have a great deal of stiffness and pain in his joints all the time. But because of his Lumbar Schurmans he generally has back pain all the time. He has lived on Ibuprofen for the last five years since his diagnosis of his back problem. Please let me know if you have any ideas or suggestions. I would truely be greatful. It took us a very long time to find someone who could diagnosis his back problems and for that we ended up a Childrens in Chicago. thank you again Sally
=
Your description of the tremor was very helpful: you indicated it was not symmetric (right hand mainly) and that it was present not at rest but with action.
Parkinson's disease (very unlikely anyway in a 15 year old) often shows up as a tremor on one side, but it is at REST rather than with ACTION. So that is probably NOT what is going on.
Essential tremor is a benign condition in which your hands shake, particularly when doing something. I've seen it in 15 year olds and in 85 year olds, and everything in between. BUT you would expect it to be symmetric, that is, BOTH hands about the same.
The above two are the most common causes of tremor. However, my suspicion is high that you son's tremor arises from damage to the cerebellum, particularly the output circuitry which connects the right hemisphere (of the cerebellum) to the next station in the brain (the left side of the thalamus). That could mean a lesion in the dentate nucleus, or in the white matter of the midbrain, or perhaps even in the thalamus itself.
If there is a structural cause (stroke, hemorrhage, tumor, vascular malformation, loss of myelin as in MS, etc), then the MRI is the best test to find it. Sometimes cerebellar damage comes from metabolic, biochemical, or genetic causes and the MRI may not really show anything.
I hope and expect your son's doctors are systematically examining him for all possibilities. Good luck to you and him. CCF MD mdf
