My Dad's Symptoms: Neck Stiffness and Hand Tremors

Q: My Dad's Symptoms: Neck Stiffness and Hand Tremors

Hello, based on your description： 1. The neck movement is stiff and not smooth. 2. The right hand shakes while writing, and the lines are not straight. These two points usually require evaluation by a neurologist. As for 3. Snoring during sleep with a simi

請提供您爸爸的症狀內容，我將為您翻譯成英語。

These are my father's symptoms (59 years old).
He visited the neurology department at Fengyuan Hospital yesterday, but the doctor only mentioned that it might be due to poor posture (didn't examine or touch him at all).
As a result, we have very little confidence in this doctor and are unsure which specialist to consult for further evaluation.
Symptoms: 1.
Stiffness and difficulty in neck rotation 2.
Tremors in the right hand while writing, resulting in wavy lines 3.
Snoring during sleep with a gasping-like appearance (as reported by my mother; he himself does not feel this) Duration: This has been ongoing for nearly six months.
Note: About three months ago, he visited a clinic where the doctor administered an injection, but there has been no improvement since then.

Guo En, 20~29 year old female. Ask Date: 2018/02/21

Dr. Ji Zhaoyun reply Otolaryngology

Hello, based on your description: 1.
The neck movement is stiff and not smooth.
2.
The right hand shakes while writing, and the lines are not straight.
These two points usually require evaluation by a neurologist.
As for 3.
Snoring during sleep with a similar appearance of not breathing (as my mother mentioned, I don't feel it), it is difficult to judge solely on your own.
Generally, if it affects daytime work and learning, or even causes fatigue while driving or doing household chores, it is more serious.
Furthermore, if family members notice that you stop breathing for more than 10 seconds during sleep, followed by a loud snore and then resuming breathing, this is also a more serious condition.
However, these are quite subjective observations.
I still recommend that you see an otolaryngologist for: 1) Sleep study: Spending a night in the hospital with some detectors attached to assess the severity of the condition.
2) Structural examination: To check for obstructive upper airway issues, such as enlarged tonsils, etc., to identify the severity and cause, so that effective treatment can be achieved.
Wishing you peace and health.
This is purely a conceptual exchange; everything should be based on the physician's actual consultation.
Sincerely, Dr.
Chi Chao-Yun, Department of Otolaryngology, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/02/21

More Info

It sounds like your father is experiencing a combination of symptoms that could be indicative of several underlying issues, particularly related to neurological health. Given his age (59 years) and the symptoms you've described—neck stiffness, hand tremors, and sleep apnea-like symptoms—there are a few potential conditions that could be at play.

1. Parkinson's Disease: The tremors in his right hand, especially when writing, could be a sign of Parkinson's disease, which is characterized by tremors, stiffness, and bradykinesia (slowness of movement). The stiffness in his neck could also be related to this condition, as rigidity is a common symptom. Parkinson's disease typically progresses slowly, and early diagnosis can significantly improve management and quality of life.

2. Cervical Spondylosis: The stiffness in his neck could also be due to cervical spondylosis, which is age-related wear and tear affecting the spinal disks in the neck. This condition can lead to pain and stiffness, and in some cases, it can compress nerves, leading to symptoms like tremors or weakness in the hands.

3. Essential Tremor: This is another possibility, especially if the tremors are more pronounced when he is trying to perform tasks. Essential tremor is a neurological disorder that causes involuntary and rhythmic shaking, often affecting the hands.

4. Sleep Apnea: The snoring and the description of "not breathing" during sleep could suggest obstructive sleep apnea, a condition where breathing repeatedly stops and starts during sleep. This can lead to poor sleep quality and daytime fatigue, which may exacerbate other symptoms.

Given the complexity of these symptoms, it is essential to seek a thorough evaluation from a neurologist who specializes in movement disorders. A comprehensive assessment may include:
- Neurological Examination: A detailed examination to assess motor skills, reflexes, and coordination.

- Imaging Studies: MRI or CT scans may be necessary to rule out structural issues in the brain or cervical spine.

- Sleep Study: If sleep apnea is suspected, a sleep study (polysomnography) can provide valuable information about his sleep patterns and breathing.

In the meantime, there are some supportive measures you can consider:
- Physical Therapy: Engaging in physical therapy can help improve neck mobility and overall strength, which may alleviate some symptoms.

- Occupational Therapy: An occupational therapist can provide strategies to manage daily tasks despite tremors, such as using weighted utensils for eating or writing.

- Lifestyle Modifications: Encourage your father to maintain a healthy lifestyle, including regular exercise, a balanced diet, and proper sleep hygiene, which can all contribute to better overall health.

It’s understandable to feel frustrated with the initial consultation and the lack of thorough examination. If you feel that your father's concerns are not being adequately addressed, it may be worthwhile to seek a second opinion from another neurologist or a specialist in movement disorders. Early intervention can make a significant difference in managing symptoms and improving quality of life.

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I'm sorry, but I can't assist with that.

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