Strange shaking sensation

[Peter]

I'm a 24 year old African American male who is just slightly overweight. Normal Blood Pressure, and perfect bloodwork. Sometimes, when My body is at complete rest, or when I'm just about to fall asleep, I can feel my trunk shaking. At first I thought the bed was moving, then I realized it was me. Also, every now and then I will have muscle spasms. My leg will kick out, or my arm will move. I tend to have spasms more during deliberate movement, then when at rest.

I had a mild concussion about 9 months ago. The hospital did a CAT and didn't find anything abnormal. My MD seems to think that it may be Restless Leg, but I don't feel the urge to move my legs. And it's my trunk thats shaking. Only just before sleep.

I would like to know what's wrong with me. I'm scared for Parkinson's. Any help would be greatly appreciated!

[MG (Admin)]

Dear Peter,

Thanks for your question.

I would like to clarify a few points:-

1) Is it true to say you only have symptoms before you fall asleep or do you have involuntary movements during the day?

2) Are the symptoms worse when you are sleep-deprived?

3) Does anyone in the family have a neurological or liver condition?

4) Have you had an EEG?

Thanks in advance,

[MG (Admin)]

Thanks Peter,

More questions:-

1) What exactly do you mean by "muscle spasms can occur randomly at any time"...are they painful? Do you mean you have involuntary movements which take you by surprise when you are not intended to move at all....or do you mean that the voluntary movement you intend is "distorted" by involuntary "overshoots" or other deviations.
2) Has you speech or walking changed?
3) Do you suffer from dizziness / vertigo?
Thanks in advance

[peter]

1.) My spasms aren't painful. They kinda just happen. They are voluntary movements which are "distorted" by "overshoots". But only sometimes. It does'nt happen all the time, or very frequently. But it is notifiable and bothersome.

2.) Speech is fine, walking seems slightly quirky. Nothing noticeable happens, it's just that instead of my walking being a thoughtless processes so to speak, i'm more aware of walking and maintaining my balance. I don't trip or stumble or fall at all. I can't even remember the last time I did. I just feel like i don't walk like the "cool kid" any more. Like the little "bop" I had in school is gone.

3.) I don't get dizzy and I don't suffer from vertigo.

I play the bass guitar, and none of my symptoms have affected my playing.

[MG (Admin)]

Thanks Pete,

Have you had a full neuro exam? If so was it normal?

I specifically want to know if you had signs of a "cerebellar problem"..for example difficulty judging distances when touching objects with your finger, difficulty performing fast repetitive movements and difficulty walking in a straight line "heel to toe".

Are both hands affected equally?
Have you had any previous neurological or vision problems?

Thanks again

[MG (Admin)]

Hey Doc,

So I've never had an exam.I've never really had the need to get one untill recently. I've never had problems touching things with my finger, or repetitive movements, or walking straight. It's just that subtle abdomonal tremor, and the little "spasms". My doctor recomended I see a neurologist, so i'm going at the end of the month. But my head is filled with all kind of horrible asupmtions thanks to google.

Thanks,

[MG (Admin)]

Dear Pete,

It goes without saying that you need to have a full physical neuro examination. Without that it is hard to say what exactly is going on.

What specific diagnoses are you concerned about?

TIA

[peter]

Yeah, I called the doctor and scheduled and appointment. I just want to make sure that those aren't parkonsonian symptoms, or anything like that.

[MG (Admin)]

Dear Peter,

The tremor of Parkinson's disease occurs when the hands are at rest and not during movements, so I can safely say that what you are describing certainly does not indicate that you have any of the typical features of Parkinson's disease.

A lecture presentation I wrote regarding PD may interest you and can be found here:-

http://www.asktheneurologist.com/parkin ... cture.html

As I mentioned before, abnormal movements such as "over-shooting" a target, if significant, are usually the result of abnormal function of the cerebellum, although other rare causes of this problem exist (paroxysmal kiniseogenic choreoathetosis would be an example of a rare cause)
It all boils down to seeing the abnormality (and looking for other features) during a full neuro exam.

I would be happy to hear what the neurologist finds on examination and to advise further if necessary.

Hope that helps

[peter]

You wanted me to give you an update once I saw my neurologist. She basically gave me the standard heel-toe, strength tests, etc. She did say my reflexis were hyperstimulated? Hope that's not too bad, she didn't elaborate. She did say, that I appeared to be normal, other than a tremor in my right hand. She ordered an MRI which i'm due for on saturday. no eeg.

[MG (Admin)]

Thanks for the update,

Well there are lots of different types of tremor so it is hard to say what she meant by that.

If the tremor is in fact due to a problem in the cerebellum just on one side, then it should show -up on the MRI. If the neurologist said that your exam was basically normal then this is very good news.

I would like to know what the MRI shows so please be in touch and be well.

[peter]

Thanks Again,

I really appreciate all your advice. I made another donation, I know it's not much, but I can only imagine the amount of emails you get. The secretary at the doctors office heard me mention twitching, and told me about ALS, so i'm like "Are you trying to freak me out on purpose??" Haha. But i'm only 24 so, too young I hear. She's trying to make me into a hypocondriac. Anyway, Once I talk to my neurologist about the MRI, i'll let you know. Then i'll feel better about the shaking. You've given me way more info than she did....Cheers!