Hand Tremors and Weakness: When to Seek Medical Advice

Tremors, feelings of depression, blood pressure 168/74?

Hello doctor, I sometimes experience weakness in my hands and feet (I eat normally three meals a day), averaging about two days a month with this condition.
This symptom started around the fifth grade of elementary school.
When I try to exert force with my hands, they tend to tremble slightly; I should say that unless I completely relax my hand, my fingers will continuously tremble a little.
Although my legs don’t feel like they are trembling, there is a sense of weakness, and when it gets severe, my entire leg not only feels weak but also very stimulated.
There was one time in middle school when the stimulation was so intense that I sat on the ground all afternoon because my hands were trembling and my legs felt unbearable.
My overall mental state was also poor (I had been in a good mood before the symptoms occurred that day).
So besides the trembling hands and weak legs, my mood also becomes quite depressed.
I suspect it might be related to hormonal issues, and I would like to know what the doctor thinks the problem might be and whether it is necessary to see a doctor.

zero point zero, 10~19 year old female. Ask Date: 2020/04/21

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the more common causes to rule out include thyroid abnormalities and the possibility of sympathetic nervous system instability.
The causes of tremors can be categorized into four types:
1.
Physiological tremors: These do not occur regularly and are only present in certain situations such as stress, tension, or anger.
Some medications, such as bronchodilators, as well as the consumption of beverages like coffee, tea, or cola, can also lead to physiological tremors.
2.
Psychological tremors: These may occur intermittently without a fixed pattern.
Treatment focuses on addressing the underlying mental health issues and managing stress.
3.
Essential tremors: The exact cause of these tremors cannot be identified; they may be due to a unique constitution or hereditary factors.
Typically, these tremors are more pronounced when holding objects, while some individuals may experience tremors when writing or performing specific actions.
4.
Pathological tremors: These are caused by dysfunction in the nervous system, such as in Parkinson's disease, lesions in the midbrain, cerebellum, or basal ganglia, and metabolic abnormalities (like hypoglycemia or hyperthyroidism).
These types of tremors tend to be more persistent.
I recommend consulting a neurologist for discussion and treatment.
Wishing you good health and peace.
Dr.
Jiang from the Neurology Department cares about you.
However, due to the recent surge in COVID-19 cases, it is advisable to wait until the situation stabilizes before visiting the hospital for examination.
Please also implement self-protection measures and maintain cleanliness and disinfection before and after seeking medical care.

Reply Date: 2020/04/21

More Info

When experiencing hand tremors and weakness, especially if these symptoms have persisted for a long time, it is crucial to seek medical advice. The symptoms you describe—hand tremors when trying to exert force, feelings of weakness in your legs, and even emotional fluctuations—can be indicative of various underlying conditions that require professional evaluation.

Tremors can arise from several causes, including essential tremor, Parkinson's disease, anxiety, or even thyroid dysfunction. Essential tremor is a common neurological condition that causes involuntary shaking, particularly when trying to use the affected muscles. It is often familial, meaning it can run in families. On the other hand, Parkinson's disease is a progressive neurological disorder that can also present with tremors, stiffness, and bradykinesia (slowness of movement). Anxiety can lead to physiological responses that manifest as tremors and weakness, particularly in stressful situations.

The weakness in your legs, coupled with the sensation of stimulation or discomfort, may suggest peripheral nerve involvement or even issues related to your spinal cord. Conditions such as multiple sclerosis (MS) or neuropathy could lead to these symptoms. MS is an autoimmune disease that affects the central nervous system and can cause a wide range of symptoms, including weakness, tremors, and emotional disturbances. Neuropathy, which can be caused by diabetes, vitamin deficiencies, or other systemic diseases, can lead to weakness and abnormal sensations in the limbs.

Given that you have experienced these symptoms since elementary school, it is essential to consider a comprehensive evaluation. A neurologist would be well-suited to assess your symptoms through a detailed history, physical examination, and possibly further testing such as MRI scans, nerve conduction studies, or blood tests to rule out metabolic or autoimmune disorders.

In addition to the physical symptoms, you mentioned experiencing emotional changes, such as feeling down or depressed. This is not uncommon, as chronic physical symptoms can significantly impact mental health. It is essential to address both the physical and emotional aspects of your health. If you find that your mood is affected, discussing this with a healthcare provider can lead to a more holistic approach to your treatment.

In summary, while it is possible that your symptoms may not indicate a severe underlying condition, it is always better to err on the side of caution. Consulting with a healthcare professional can provide clarity and potentially lead to effective management strategies. Early intervention can often lead to better outcomes, so do not hesitate to seek help. Your health and well-being are paramount, and addressing these symptoms with a professional can help you regain control over your life.

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