Tremors, Shking Trunk, Spams

[poneal]

  I'm a 24 Year Old Male, with Pefect Bloodwork, 5'6, 215 lbs. For about the past 5- 6months i've been expriencing wierd things. My Trunk (abdomen) shakes just before I fall asleep, or if I'm at a prolonged resting position. The shaking is not visible for others to see, but I can feel it, internally. At first I thought it was the bed shaking. Then I realized it was me. My fiance dosen't notice me shaking. And it dosen't happen all the time.
  
  Also, sometimes when i'm sleep, my leg will kick, and wake me up. And My arms, legs, or fingers are known to spasm at anytime. Sometimes, if I'm making a deliberate movement, i'll over do it. Like moving the mouse on the computer, or typing. I'll go to move my hand an inch, but it will jerk forward slightly, and cause me to over shoot my target. Dosen't happen all the time. Also sometimes, my hands will shake like i'm trembling. But mostly when I'm hungry? Weird.

This is freaking me out. I did have a mild consussion about 9 months ago. Doc couldn't find anything wrong on a CAT scan. I had a horrible headache for a week, then minor periodic ones for about 5 months. I'm not really sure what to do now. I'm beginning to get worried. Parkinson's is the only disease I know of that makes people shake, although i'm sure there are others. What's causing this? My MD is baffled...Any help would be greatly appreciated. Thanks in advance, i know that was long......

Pete

[Joyce K Lee, MD]

Dear poneal,

Thank you for submitting your question.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer a diagnosis based on your history and list of symptoms.
I am extremely limited in not having the opportunity to perform a full neurologic examination on you, nor am I able to review the pertinent imaging.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.

Based on your comments, I gather that you have been experiencing "internal" or subjective shakes in your abdomen, along with some spasms or jerks over the past 6 months.

In reading your submission, what first came to my mind was myoclonic jerks.

Please allow me to offer you a brief educational segment on myoclonus, or myoclonic jerks.

Myoclonus describes a symptom and generally is not a diagnosis of a disease. It refers to sudden, involuntary jerking of a muscle or group of muscles. Myoclonic twitches or jerks usually are caused by sudden muscle contractions, called positive myoclonus, or by muscle relaxation, called negative myoclonus. Myoclonic jerks may occur alone or in sequence, in a pattern or without pattern. They may occur infrequently or many times each minute. Myoclonus sometimes occurs in response to an external event or when a person attempts to make a movement. The twitching cannot be controlled by the person experiencing it.

In its simplest form, myoclonus consists of a muscle twitch followed by relaxation. A hiccup is an example of this type of myoclonus. Other familiar examples of myoclonus are the jerks or "sleep starts" that some people experience while drifting off to sleep. These simple forms of myoclonus occur in normal, healthy persons and cause no difficulties. When more widespread, myoclonus may involve persistent, shock-like contractions in a group of muscles. In some cases, myoclonus begins in one region of the body and spreads to muscles in other areas. More severe cases of myoclonus can distort movement and severely limit a person's ability to eat, talk, or walk. These types of myoclonus may indicate an underlying disorder in the brain or nerves.

Myoclonus may develop in response to infection, head or spinal cord injury, stroke, brain tumors, kidney or liver failure, lipid storage disease, chemical or drug poisoning, or other disorders. Prolonged oxygen deprivation to the brain, called hypoxia, may result in posthypoxic myoclonus. Myoclonus can occur by itself, but most often it is one of several symptoms associated with a wide variety of nervous system disorders. For example, myoclonic jerking may develop in patients with multiple sclerosis, Parkinson's disease, Alzheimer's disease, or Creutzfeldt-Jakob disease. Myoclonic jerks commonly occur in persons with epilepsy, a disorder in which the electrical activity in the brain becomes disordered leading to seizures.

Please allow me to stop here and emphasize the importance of you knowing that I am in no way telling you that you have Parkinson's or Alzheimer's, etc.

There are many BENIGN forms of myoclonus as well.
For example, sleep myoclonus or essential myoclonus -- both of which occur in normal people.

Perhaps your concussion 9 months ago could be a contributing factor.

Treatment of myoclonus focuses on medications that may help reduce symptoms. The drug of first choice to treat myoclonus, especially certain types of action myoclonus, is clonazepam, a type of tranquilizer. Dosages of clonazepam usually are increased gradually until the patient improves or side effects become harmful. Drowsiness and loss of coordination are common side effects. The beneficial effects of clonazepam may diminish over time if the patient develops a tolerance for the drug.
Many of the anti-seizure medications are now being used to treat various forms of myoclonus as well.

This is what I suggest.
If you haven't seen a neurologist, please do so.
A CT scan of the brain is a good preliminary test -- but in light of your head injury in the past, I recommend an MRI.
It is much more sensitive with picking up smaller and more subtle abnormalities.
Inquire about a sleep study to look for abnormal sleep patterns or abnormal leg movements during sleep.
You may also inquire about an EEG (electroencephalogram) to look at your brain wave activity and possible an EMG (electromyography) to look for abnormal nerve and muscle problems.

Hope this helps,
Best of luck,
JKL, MD

[piveir]

Hi I'm Chris,
I am not a doctor but I had most of the same symptoms you described plus pain and numbness in my neck and arms. My doctor had me do an MRI on my brain first, which was inconclusive, then my neck which revealed spinal stenosis, foraminal stenosis, and spondylosis. My Nuerosurgeon told me that I needed fusion at c5/6 and c6/7. I was looking on this site for objective cases of fusion since i will have the surgery in a few weeks when i read your post. My symptoms were exactly like yours plus some. In the mornings my tremors were almost non-existent. My neck pain and the symptoms above that you described seemed to me to be coincidental. You may want to have your doctor examine your neck. Post here and let us know what they say.

[Tony963]

It sounds like lyme's disease. I would be 99.999999999999999999%
surprised if it's not. You must look for an LLMD. Do a search on WebMD site for lime's. Only 40% of people infected with limes test positive for the lyme's titter. You must see an LLMD and take it from there. Most doctors are ignorant when it comes to lyme's, because the FDA and Medical society does not have a protochol for lymes beyond the usual positive titter and doses of doxy, and /or rocephin for 28 days. That is not enouth for treatment.
Good luck and do that search now for an LLMD around you or go to the WebMD site and do a search on Lyme's Disease.