Tremors

[iansmom614]

I am 25 years old (female). For 3 weeks I have had tremors in my chin. They only happen when my mouth is at rest (they do not happen when I am speaking or chewing). I have been chewing a lot of gum! For the past 2 weeks I have also been having tremors in my left hand, arm and my left leg feels tight. These to are only when I am just sitting still. They go away when I am sleeping. I have also been tired, irritable and feeling like I have to really think about things I am doing sometimes. I have been seeing a neurologist and she has done blood work, eeg and mri. They all came back normal. I am concerned and I would really appreciate your thoughts. Thank you!

[Godofredo MD]

Hi.

There are several conditions that can possibly explain your symptoms.

Although probably unlikely the cause in your case as it is rare, there is a condition known as geniospasm (isolated chin tremor) which is an autosomal dominant hereditary syndrome characterized by episodic, usually stress-induced, high-frequency, contraction of the mentalis muscle. Its onset is typically in infancy or childhood.

Another tremor to consider in your case is resting tremor.  Your clinical presentation reports the tremor to occur when you are just sitting still.

Lastly, there is something called physiologic tremor. Physiologic tremors are normal and reflects the precise moment-by-moment control by nerves of the muscles.  Usually, the tremors are too slight to be even noticed.  

However there are certain factors that can make a physiologic tremor more noticeable, including anxiety, stress, fatigue, drug or alcohol withdrawal, hyperthyroidism, coffee intake, and use of certain drugs such as theophylline, albuterol, corticosteroids, and valproic acid. You mentioned feeling "irritable and have to really think about things you are doing sometimes". Are you anxious about something or have you been experiencing any emotional distress?

I would advise you to talk to a therapist to assess this possible cause of your tremors.

Good luck.

[iansmom614]

Thank you for responding. My thyroid has been tested it is normal. All my lab work is normal. Any other thoughts?

[Dennis MD]

Hi.
Have you been tested for thyroid problem?
Tremors could also be due to hyperthyroidism.
Aside from that, your other symptoms (fatigue, irritability) could also point to hyperthyroidism.
If your thyroid function has not been tested, I would suggest to have it done to rule out possibility of thyroid problem causing your symptoms.
Good luck.