Unexplained Body Tremors: A Neurological Perspective

Involuntary body shaking?

Hello doctor, about a week ago while I was at work, I suddenly started feeling dizzy and unsteady.
It’s not a spinning sensation, nor do I see objects moving; I don’t experience double vision.
Occasionally, I feel a bit nauseous and uncomfortable, and sometimes I sway back and forth, side to side, or in a circular motion, which makes me feel slightly off balance.
For almost the entire week, I have been feeling this way, with only one morning where I felt fine after waking up, but a few hours later, the dizziness returned and lasted all day.
I don’t feel this sensation while sleeping or riding a bike.
In the meantime, I visited an ENT specialist who diagnosed me with Eustachian tube inflammation, as I had mild nasal congestion a day or two before seeking medical attention.
However, after taking the medication, my condition worsened instead of improving.
I have no discomfort in my ears (such as tinnitus, fullness, pain, or hearing loss).
Taking anti-dizziness medication has not helped at all.
While it’s not debilitating, it has become very difficult for me to concentrate and think clearly; my mind feels foggy and noisy.
I also experience tingling sensations in the fingers of my right hand and the toes of my right foot.
I have no history of hypertension, diabetes, or any trauma.

Joyce, 20~29 year old female. Ask Date: 2023/05/05

Dr. Jiang Junyi reply Neurology

Hello Ms.
Joyce,
Could you please clarify whether the "tingling sensation in the fingers of your right hand and the toes of your right foot" occurs simultaneously with the dizziness, or has this symptom been present for a long time? If they occur at the same time, we may need to consider abnormalities in the brainstem nerves.
If they are independent events, it would be advisable to first consider migraine-associated vertigo.
Vertigo: This may last from a few minutes to several days and is usually related to migraine attacks.

Headache: Typically unilateral and pulsating, it may be accompanied by nausea, vomiting, photophobia, and phonophobia.
Aura symptoms: Symptoms such as visual, sensory, or speech disturbances may occur before the onset of the headache.
Balance disturbances: You may feel unstable while standing or walking.
I recommend that you consult a neurologist to discuss examination and treatment options.
Thank you for your inquiry, and feel free to discuss further.
Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital

Reply Date: 2023/05/05

More Info

Understanding unexplained body tremors can be quite complex, especially when they are accompanied by symptoms such as dizziness and a feeling of imbalance. Based on your description, it seems that you are experiencing a combination of neurological and possibly vestibular symptoms. Let's break down the potential causes and considerations for your situation.

Firstly, the sensation of dizziness that you describe, which is not vertigo (the sensation of spinning), could be related to several factors. You mentioned that you experienced some nasal congestion prior to the onset of your symptoms, and your ENT specialist diagnosed you with eustachian tube dysfunction due to inflammation. This condition can lead to a feeling of fullness in the ears and can affect balance, as the inner ear plays a crucial role in maintaining equilibrium. However, since you noted that your symptoms worsened despite treatment, it may be worth exploring other underlying causes.

The symptoms of body tremors, dizziness, and the feeling of heaviness in your head could also be indicative of a neurological issue. For instance, conditions such as anxiety or stress can manifest physically, leading to tremors and a sense of disorientation. It’s not uncommon for individuals to experience heightened anxiety in response to unexplained physical symptoms, which can create a feedback loop of discomfort and anxiety.

Another possibility to consider is the role of the central nervous system. The brain processes sensory information and coordinates motor functions, so any disruption in this system can lead to symptoms like tremors and dizziness. Conditions such as multiple sclerosis (MS) or other demyelinating diseases can present with similar symptoms, although they typically come with additional neurological signs. Given that you have not experienced any trauma or have a history of chronic diseases like diabetes or hypertension, these conditions may be less likely but should still be considered.

Peripheral neuropathy, which can cause tingling and numbness in the extremities, could also be a factor. This condition can arise from various causes, including vitamin deficiencies, alcohol use, or certain medications. Since you mentioned experiencing tingling in your fingers and toes, it may be beneficial to evaluate your nutritional status and any potential exposure to toxins.

In terms of immediate steps, I recommend the following:
1. Follow-Up with a Neurologist: Given the complexity of your symptoms, a consultation with a neurologist may provide further insights. They may recommend tests such as MRI or nerve conduction studies to rule out neurological conditions.

2. Vestibular Rehabilitation: If your symptoms are related to balance issues, vestibular rehabilitation therapy could help improve your symptoms. This therapy focuses on exercises that help your brain adapt to the changes in balance and reduce dizziness.

3. Monitor Symptoms: Keep a detailed log of your symptoms, including when they occur, their duration, and any associated factors (like stress levels, diet, or sleep patterns). This information can be invaluable for your healthcare provider.

4. Consider Psychological Factors: If anxiety or stress is contributing to your symptoms, cognitive-behavioral therapy (CBT) or mindfulness techniques may help manage these feelings.

5. Lifestyle Modifications: Ensure you are maintaining a balanced diet, staying hydrated, and getting adequate sleep. These factors can significantly impact your overall health and may help alleviate some of your symptoms.

In conclusion, while your symptoms may be linked to eustachian tube dysfunction, it is essential to consider a broader range of potential neurological and psychological factors. A thorough evaluation by a healthcare professional will be crucial in determining the underlying cause and appropriate treatment for your condition. Remember that you are not alone in this experience, and seeking help is a vital step toward understanding and managing your symptoms.

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