Involuntary Hand Movements: Causes and Solutions

Involuntary hand movements?

Hello Doctor: Since around the fifth grade, my right hand has been experiencing involuntary twitching, similar to a reaction as if being shocked, but it is not painful or numb.
I have seen a neurologist before, but nothing came of it.
However, this symptom has severely impacted my life.
Recently, as I prepare for a national exam, my hand trembles even more when I hold a pen.
Previously, I would twitch once while writing a line, but in the past few months, it has become more pronounced, resembling a stroke, to the point where I struggle to hold a pen and can only write about three characters before it twitches.
In the past, it wouldn't twitch without any movement, but now it twitches even when I'm still, which often startles me and those around me.
I've also noticed that it twitches while walking.
I have had blood tests, and both copper and ceruloplasmin levels were low in four separate tests, raising suspicion for Wilson's disease, but Chang Gung Hospital ruled that out.
My thyroid is also fine, and an MRI showed no issues.
So what is happening to me? Are there any other tests I should consider? I am very afraid that I might end up unable to walk.

QQ, 20~29 year old female. Ask Date: 2016/07/02

Dr. Gao Chunde reply Neurology

The symptoms are becoming more pronounced, and it is recommended to visit a medical center's movement disorders clinic for a detailed examination.
The underlying cause should be identifiable, but it may require some patience.

Reply Date: 2016/07/02

More Info

Involuntary hand movements, such as the twitching or shaking you describe, can be distressing and significantly impact daily life, especially when they interfere with tasks like writing or holding objects. Based on your description, it seems that you have been experiencing these involuntary movements since elementary school, and they have worsened over time. Here are some potential causes and solutions to consider.

Possible Causes
1. Essential Tremor: This is a common neurological condition that causes rhythmic shaking, particularly in the hands. It often becomes more noticeable when performing tasks that require fine motor skills, such as writing or holding a pen. Essential tremor can be hereditary and may not be associated with any other neurological symptoms.

2. Dystonia: This movement disorder causes involuntary muscle contractions, leading to abnormal postures or movements. It can affect one hand or both and may worsen with specific tasks, such as writing.

3. Anxiety or Stress: Psychological factors can also manifest physically. Anxiety can lead to muscle tension and tremors, particularly in situations that require focus or precision, such as taking an exam.

4. Neurological Disorders: While you have undergone various tests, including MRI and blood tests, some neurological conditions can cause involuntary movements. Conditions like Parkinson's disease or Wilson's disease (though ruled out in your case) can lead to tremors or other movement disorders.

5. Peripheral Neuropathy: Damage to the peripheral nerves can lead to involuntary movements or twitching. This can be due to various factors, including vitamin deficiencies, diabetes, or other metabolic disorders.

6. Medication Side Effects: If you are taking any medications, it's worth considering whether they could be contributing to your symptoms. Some medications can cause tremors or involuntary movements as side effects.

Recommended Solutions
1. Consult a Movement Disorder Specialist: Since your symptoms have persisted and worsened, it would be beneficial to see a neurologist specializing in movement disorders. They can conduct a thorough evaluation and may recommend additional tests, such as electromyography (EMG) or nerve conduction studies, to assess muscle and nerve function.

2. Physical Therapy: Engaging in physical therapy can help improve muscle control and coordination. A therapist can work with you on exercises that may help reduce involuntary movements and improve overall motor function.

3. Stress Management Techniques: Since anxiety can exacerbate involuntary movements, consider incorporating stress-reduction techniques into your routine. Mindfulness, meditation, and deep-breathing exercises can help manage anxiety levels.

4. Medication: If a specific diagnosis is made, there may be medications available that can help manage your symptoms. For example, beta-blockers are often prescribed for essential tremor, while other medications may be used for dystonia.

5. Lifestyle Modifications: Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep, can positively impact your overall well-being and may help reduce symptoms.

6. Support Groups: Connecting with others who experience similar symptoms can provide emotional support and practical advice. Look for local or online support groups for individuals with movement disorders.

Conclusion
Involuntary hand movements can stem from a variety of causes, and it is essential to pursue a comprehensive evaluation to determine the underlying issue. While it can be frustrating to navigate this process, working closely with healthcare professionals can lead to effective management strategies. Remember that you are not alone in this, and there are resources available to help you cope with and understand your symptoms better.

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