Internal Tremors: When to Seek Neurological Help

Q: Internal Tremors: When to Seek Neurological Help

Hello： Your first question concerns body tremors. <br>It may be necessary to consider that muscle tension is excessively high due to an inability to relax. <br>Clinically, symptoms are often improved through relaxation training or the use of sedative medications. <br>It is recomm

Internal tremors

Hello, doctor.
I have a question.
When I wake up from sleep and lie flat, I feel a tremor in my body, although there is no visible shaking.
It feels as if there are two hearts beating inside me, accompanied by numbness in my palms upon waking.
Occasionally, I also feel this internal tremor while sitting on the toilet.
An echocardiogram showed mild left ventricular hypertrophy due to high blood pressure, but no other issues were found.
I tend to be anxious and nervous by nature.
This problem has been ongoing for about a year.
Which specialty should I consult? Additionally, I don't usually experience dizziness or headaches, but occasionally I have brief episodes of sudden dizziness that last about a second.
I'm unsure what might be causing this.
I would appreciate your insights on both issues.
Thank you.

Mi Mi, 40~49 year old female. Ask Date: 2020/05/27

Dr. Jiang Junyi reply Neurology

Hello: Your first question concerns body tremors.
It may be necessary to consider that muscle tension is excessively high due to an inability to relax.
Clinically, symptoms are often improved through relaxation training or the use of sedative medications.
It is recommended that you consult a neurologist or a psychosomatic medicine specialist for further examination and medication adjustment.

Your second question pertains to brief episodes of dizziness.
This may be indicative of "benign paroxysmal positional vertigo" (BPPV), which often has an unknown cause.
Some causes include inflammation, degeneration, or dislodgment of otoliths in the utricle of the inner ear following head trauma, which then enter the semicircular canals.
When the head position changes, the movement of the otoliths within the semicircular canals causes changes in the neural potentials of the inner ear, resulting in vertigo.
Patients with benign paroxysmal positional vertigo are predominantly female.
It is advisable to consult an otolaryngologist and a neurologist to discuss examination and treatment options.
Wishing you good health and peace.

Dr.
Jiang, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2020/05/27

More Info

Understanding internal tremors can be quite perplexing, especially when they manifest without any visible signs. In your case, the sensation of internal shaking, particularly upon waking or while lying down, combined with symptoms like hand numbness, can be indicative of several underlying issues. Given your history of anxiety and hypertension, it’s essential to approach this matter with a comprehensive understanding.

Internal tremors are often described as a feeling of shaking or vibrating within the body, which can occur without any external manifestation. This sensation can be linked to various conditions, including anxiety disorders, neurological issues, or even side effects from medications. In your situation, the fact that you experience these tremors primarily upon waking and in specific positions may suggest a few possibilities.

1. Anxiety and Stress: Since you mentioned that you tend to be easily anxious, it’s important to consider that anxiety can lead to physical symptoms, including internal tremors. The body’s response to stress can sometimes create sensations that mimic tremors, especially during periods of relaxation or upon waking when the body transitions from a state of rest to activity.

2. Neurological Considerations: While your echocardiogram results were normal aside from hypertension and mild cardiac hypertrophy, the internal tremors and hand numbness could warrant a neurological evaluation. Conditions such as essential tremor, Parkinson's disease, or even peripheral neuropathy could potentially cause similar symptoms. A neurologist would be able to conduct a thorough examination, possibly including imaging studies or nerve conduction tests, to rule out any serious neurological conditions.

3. Sleep Disorders: The timing of your symptoms, particularly upon waking, could also suggest a sleep-related issue. Conditions like sleep apnea can lead to fragmented sleep and subsequent symptoms of fatigue and internal tremors. If you often feel unrested after sleep, it might be worth discussing sleep studies with your healthcare provider.

4. Medication Side Effects: If you are taking any medications for hypertension or anxiety, it’s crucial to review these with your doctor. Some medications can lead to tremors or sensations of shaking as side effects.
5. Other Medical Conditions: Conditions such as hyperthyroidism or electrolyte imbalances can also lead to tremors. A comprehensive metabolic panel could help identify any underlying issues that might be contributing to your symptoms.

Regarding the occasional dizziness you experience, this could be related to a variety of factors, including blood pressure fluctuations, dehydration, or even anxiety. It’s essential to monitor when these episodes occur and discuss them with your healthcare provider, as they may require further investigation.

In summary, it would be prudent to seek an evaluation from a neurologist to explore the internal tremors and numbness further. They can provide a more targeted assessment and recommend appropriate tests to determine the underlying cause of your symptoms. Additionally, addressing your anxiety through therapy or lifestyle changes could also help alleviate some of the physical manifestations you are experiencing. Remember, it’s important to communicate all your symptoms clearly to your healthcare provider to ensure a comprehensive approach to your health.

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