Severe hand tremors after head injury

[pjake]

My 87 year old mother had a severe accident in her bathroom a month and a half ago and passed out, fell into her cast iron tub and was unconscious for at least an hour or more.  When she came too, she managed to fall out of the bathtub, reach up and hit her medical Alert button from ADT to summon help which arrived within 5 minutes.  She was able to crawl 50' down her hallway to the door, stand up and let my sister and the paramedics inside to assist her, telling them that her neck hurt.  When she was taken to the hospital and had a CT scan she was found to have a C2 total break, and she was sent to a trauma hospital for care where they put a halo on, put her in surgery the next day for an odontoid screw to hold her bones in her neck together and since her heart rate was so slow they also inserted a pacemaker immediately after the surgery for the odontoid pin being installed.  She went to rehab within a week and completed that.  No paralysis, which the doctors were all amazed, she went through rehab a willing patient and now she is up and around with a halo still on her head.  She doesn't seem to have any brain damage in any shape, though the entire left side of her face was broken, the eye socket was smashed so badly no surgery could be done.  Her eye on that side seems much larger than the other eye and seems to look "bug eyed" which is kind of weird to look at.  Probably other people wouldn't notice it as much as we do, but it is noticeable to us in a big way.  Since her entire face was a mass of bloody bruises and swollen tissue with sutured cuts all on her head and lips, and we didn't see her looking anything like our mother's face for a month, she looks great, with some bruises still very visible.  The problem we are noticing now is that she will have periods of uncontrollable shaking when she is brushing her teeth, or trying to pick up food to get to her mouth, put in her hearing aids, or read a piece of paper.  It seems like it is more telling when she is trying to do tedious things.  It isn't all of the time like a Parkinson's patient, but periodic.  Every day at this point, but not all day.  Mostly in the evening time.  The doctors don't seem too concerned, but it is very disconcerting to her family.  Does anyone know if this is a norm after a head injury?  Will it go away?  Is there anything that can be done about it?  She is only on blood pressure medicine (not much), Calcium and Vitamin D and an anti depressant at this point.  She was on these same medicines prior to the injury, so we don't think it is medicine related.  Any information would be appreciated if you have gone through this before.  Also, does anyone know if the halo is removed with medication administered for pain (or fear?)  She is greatly apprehensive about the removal of this brace as she was in intense pain when it was put on and still remembers the screws being screwed into her head with no medication.    

[pjake]

I am thinking that you are right about this.  She has an extremely high tolerance for pain and throughout the entire ordeal, the first day she took Dilaudid and Morphine and from the second day on she told them she only wanted Tylenol.  Not Tylenol 3, but just Tylenol.  The doctor told her that she could have something more, but she said "okay, give me 2 Tylenol" so she did the rest of the time in the hospital with Tylenol and this lady had been really so bad off we couldn't recognize her with bloody cuts and swelling.  She may be in pain right now and would never tell us.  When we ask her she says no.  She told me it is when she is nervous, but we have all noticed it is all at random times and not when she is nervous.  We will definitely get her something before the halo is removed because she is terrified of that.  Thanks for your input.  I never thought it could be pain, but it just may be.  She just never had them before the accident.  They are very Parkinsonian in appearance.