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Neurology (Expert Forum)
Burning sensation in hands, tremor (is it gonna be like this forever?)
Answered by
Esteban Cheng-Ching, MD - Neurology, Internal Medicine
Cleveland Clinic
Cleveland - OH
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
Burning sensation in hands, tremor (is it gonna be like this forever?)
by avon2k4, Jul 11, 2008 09:22AM
Description:
I'm 22 years old and I have tremor in my whole right arm even when at rest. The tremor is not obvious in that ppl won't be able to notice it, but I can feel my muscles inside slightly vibrating/oscilating. When I use the computer mouse i usually feel a slight burning sensation on my finger tips and my palm, which becomes more and more unbearable if i don't stop using the mouse.
What I've done:
Went to doctor already, cervical spine x-ray says it is straightened, muscle enzyme (thyroid) test is normal, blood sugar test is also normal, emg-ncv is also normal.
What they say:
They say that it's probably bec of stress (w/c i don't agree with). Told me to take Vit B complex and B12, and gabapentine (neurlogical pain reliever) as needed. I've been taking vitamins for more than two months now and there seems to be no improvement. One time I felt almost healed but it came back again. I'm kind of running out of options now and dunno what to do.
What do you think of my condition?
Thank you so much.
I'm 22 years old and I have tremor in my whole right arm even when at rest. The tremor is not obvious in that ppl won't be able to notice it, but I can feel my muscles inside slightly vibrating/oscilating. When I use the computer mouse i usually feel a slight burning sensation on my finger tips and my palm, which becomes more and more unbearable if i don't stop using the mouse.
What I've done:
Went to doctor already, cervical spine x-ray says it is straightened, muscle enzyme (thyroid) test is normal, blood sugar test is also normal, emg-ncv is also normal.
What they say:
They say that it's probably bec of stress (w/c i don't agree with). Told me to take Vit B complex and B12, and gabapentine (neurlogical pain reliever) as needed. I've been taking vitamins for more than two months now and there seems to be no improvement. One time I felt almost healed but it came back again. I'm kind of running out of options now and dunno what to do.
What do you think of my condition?
Thank you so much.
Doctor's Answer
by Esteban Cheng-Ching, MD, Jul 15, 2008 02:22PM
, Jul 15, 2008 02:22PM
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to review your medical history and examine you, I can not tell you what is causing your symptoms, but I will do my best to provide you with information regarding your symptoms in general.
Tremor is caused by multiple conditions, and is usually classified in action tremor and resting tremor. Action tremor happens when there it is elicited by movement, and resting tremor is when it happens at rest.
Tremor can be caused by medications and drugs, including caffeine and other stimulants. Can as well be part of a systemic illness such as hyperthyroidism, anxiety, fever, etc, but usually these cause more generalized tremor and not only in one extremity.
Of course whenever people have tremors they are concerned about the possibility of Parkinson’s disease, however this should be evaluated in the context of the patient, including age (usually older ages) and other manifestations such as rigidity, slowness of movement, changes in facial expression, etc. Not like what you describe.
Other conditions to be considered when there is tremor include physiologic tremor, essential tremor, primary writing tremor, cerebellar tremors, neuropathic tremors.
It is difficult to characterize your tremor within these categories based on your history, the focality to the right side, and the fact that it cannot be seen externally.
The other symptom, tingling in the hand could be caused by a neuropathy (problem with the nerves), and for it to be localized to one hand, likely it is either related to trauma or compression. However symptoms from neuropathy are usually persistent or constant, and EMG-NCV makes the diagnosis usually 2 weeks after the onset, and it seems that you already had this test and it was not abnormal. The fact that you said that at some point the symptom improved, but relapsed, and that it appears when you use the mouse, makes me think that it could be related to a specific position or activity you do with that hand (or arm) that produces a transient nerve compression, and when you stop that position or activity for some time, the symptoms improve. However I cannot prove this just from your description.
I really cannot tie both symptoms together.
Based on what you describe I cannot make a diagnosis, and cannot tell you what your problem is. However I think that you should see a neurologist in order to do a proper neurologic work up and make a diagnosis.
Thanks for using the forum. I hope this helps.
Without the ability to review your medical history and examine you, I can not tell you what is causing your symptoms, but I will do my best to provide you with information regarding your symptoms in general.
Tremor is caused by multiple conditions, and is usually classified in action tremor and resting tremor. Action tremor happens when there it is elicited by movement, and resting tremor is when it happens at rest.
Tremor can be caused by medications and drugs, including caffeine and other stimulants. Can as well be part of a systemic illness such as hyperthyroidism, anxiety, fever, etc, but usually these cause more generalized tremor and not only in one extremity.
Of course whenever people have tremors they are concerned about the possibility of Parkinson’s disease, however this should be evaluated in the context of the patient, including age (usually older ages) and other manifestations such as rigidity, slowness of movement, changes in facial expression, etc. Not like what you describe.
Other conditions to be considered when there is tremor include physiologic tremor, essential tremor, primary writing tremor, cerebellar tremors, neuropathic tremors.
It is difficult to characterize your tremor within these categories based on your history, the focality to the right side, and the fact that it cannot be seen externally.
The other symptom, tingling in the hand could be caused by a neuropathy (problem with the nerves), and for it to be localized to one hand, likely it is either related to trauma or compression. However symptoms from neuropathy are usually persistent or constant, and EMG-NCV makes the diagnosis usually 2 weeks after the onset, and it seems that you already had this test and it was not abnormal. The fact that you said that at some point the symptom improved, but relapsed, and that it appears when you use the mouse, makes me think that it could be related to a specific position or activity you do with that hand (or arm) that produces a transient nerve compression, and when you stop that position or activity for some time, the symptoms improve. However I cannot prove this just from your description.
I really cannot tie both symptoms together.
Based on what you describe I cannot make a diagnosis, and cannot tell you what your problem is. However I think that you should see a neurologist in order to do a proper neurologic work up and make a diagnosis.
Thanks for using the forum. I hope this helps.
