Involuntary Movements: Exploring Causes and Concerns

Involuntary movements

Hello, doctor.
Previously, I experienced involuntary twitching and shaking in my hands, and I underwent tests for copper and ceruloplasmin, both of which were low.
Therefore, there was a suspicion of Wilson's disease.
The doctor advised me to go to a larger hospital.
I went there, had blood drawn, and provided a urine sample for testing.
However, the report showed that my blood copper levels (previously 44, now 98) and urine copper levels were normal, but my ceruloplasmin was still at 10.
The doctor told me that I only had an abnormal ceruloplasmin level, so that data was not of significant value.
He also mentioned that many cases of twitching and shaking are either unexplained or hereditary.
I underwent an MRI, and the doctor said everything was fine.
Could it be that there is really no cause? This issue is truly troubling me.
Could it be related to my twitching and shaking? Can I request further testing?

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

Dr. Gao Chunde reply Neurology

In fact, the physicians at larger hospitals likely consider the same potential causes that we are aware of.
They have likely thought of everything I can come up with.
If the cause cannot be identified, one possibility is that it is truly primary, meaning there is no known cause, and another possibility is that it is something that current medical instruments or knowledge cannot yet explain or resolve.
Generally, your symptoms would be evaluated in the movement disorders or involuntary movement disorders departments at a medical center, where physicians who frequently handle complex cases referred from various locations can help monitor your condition.
If there is indeed a specific underlying cause, certain changes in the disease may provide them with insights for diagnosis.
As for the tests, the physicians know which ones will be useful for you and which ones will not, so you don't need to endure unnecessary suffering.

Reply Date: 2016/07/29

More Info

Involuntary movements, such as hand tremors or twitching, can be concerning and often lead individuals to seek medical advice. Your experience with involuntary movements, particularly the hand twitching and shaking, alongside the tests for Wilson's disease, indicates that you are taking the right steps to understand your condition. Wilson's disease is a genetic disorder that leads to excessive copper accumulation in the body, which can cause neurological and psychiatric symptoms, including tremors. However, since your copper and ceruloplasmin levels are within normal ranges, it seems less likely that Wilson's disease is the cause of your symptoms.

Involuntary movements can arise from various causes, including neurological disorders, metabolic issues, stress, anxiety, or even certain medications. Given that your MRI results were normal and that your doctor has indicated that many cases of tremors may be idiopathic (without a known cause) or hereditary, it is essential to consider other potential factors that could be contributing to your symptoms.

1. Essential Tremor: This is a common movement disorder that causes rhythmic shaking, often in the hands. It can be hereditary and may worsen with stress or fatigue.

2. Anxiety and Stress: Psychological factors can significantly impact physical health. Anxiety can manifest as muscle tension and involuntary movements. If you are experiencing stress or anxiety, addressing these through therapy or relaxation techniques may help alleviate your symptoms.

3. Neurological Conditions: While your MRI was normal, other conditions such as Parkinson’s disease or dystonia could cause similar symptoms. If your symptoms persist or worsen, it may be worth discussing further neurological evaluations with your healthcare provider.

4. Medication Side Effects: If you are taking any medications, it is crucial to review them with your doctor, as some can cause tremors or involuntary movements as side effects.

5. Nutritional Deficiencies: Certain deficiencies, such as vitamin B12 or magnesium, can lead to neurological symptoms, including tremors. A comprehensive nutritional assessment may be beneficial.

6. Genetic Factors: If there is a family history of movement disorders, it may be worth exploring genetic testing or counseling to understand better any hereditary components.

Given your concerns, it is reasonable to request further evaluations or tests. You might consider asking your doctor about the possibility of seeing a neurologist specializing in movement disorders. They can provide a more in-depth assessment and may suggest additional tests, such as electromyography (EMG) or genetic testing, if appropriate.

In the meantime, keeping a symptom diary can be helpful. Document when the movements occur, their frequency, any associated stressors, and any other symptoms you may experience. This information can provide valuable insights for your healthcare provider.

Lastly, it is essential to maintain open communication with your healthcare team. If you feel that your concerns are not being adequately addressed, do not hesitate to seek a second opinion. Understanding the underlying cause of involuntary movements can be complex, but with persistence and the right support, you can find answers and appropriate management strategies.

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