Body and Head Tremors: Causes and Management Strategies

Body and head shaking?

Hello, I am currently experiencing a phenomenon (body and head shaking) that has been troubling me, and I fear that if it continues, it may severely impact my life.
Here are the details: Two years ago, I was diagnosed with hyperthyroidism and have been taking medication (PTU) regularly, with periodic check-ups.
By December 2004, I was completely fine, and my doctor advised me to stop the medication.
However, prior to this, around June 2004, my body suddenly began to shake involuntarily, especially my head (the shaking is from left to right, not very pronounced but quite uncomfortable; when it occurs, I feel as if there is an earthquake, accompanied by palpitations).
Later, I went to Taichung Veterans General Hospital for a full-body examination, and everything was generally okay, except for my chronic issue of elevated liver SGPT levels, around 77.
There were no issues with my ears or double vision, and my thyroid function tests were normal.
During a follow-up visit, the doctor suggested that this might be due to long-term stress caused by the 921 earthquake and prescribed Lexotan (1.5 mg) for anxiety, which I took for three months (one tablet in the morning and one at night).
After some improvement, I began to taper off the medication.
Initially, the reduction went well (the reason for tapering was due to back and neck stiffness, as well as side effects of the medication: drowsiness and lack of energy).
Although the shaking was not pronounced, I still felt a slight shaking in the back of my head, especially when I closed my eyes (or leaned back against something), which was very uncomfortable, as if there was a force pushing me.
I thought it might be psychological, so I resolved to fight against this feeling.
About a month after completely stopping the medication, I began to worry about not being able to sleep at night (as the feeling of being pushed was more pronounced when I closed my eyes).
My mood was consistently low, and sometimes I felt exhausted by life, but I kept telling myself that I had to combat this feeling.
Eventually, I couldn't take it anymore and started taking half a Lexotan tablet before bed (not after meals as before) two weeks ago.
This slightly improved the situation when I closed my eyes, but the subtle shaking sensation and my mood remained poor.
Therefore, two days ago, I took one liver-protecting pill and half a Lexotan after breakfast.
My mood seemed to improve a bit, and I was better able to cope with the subtle shaking sensation, but what should I do next? Should I continue taking this anti-anxiety medication? Will I need to take it for life? (I feel drowsy and have stiffness in my back and neck.) Is the stiffness in my back and neck a result of the medication? Recently, the results of the medication seem to be better, but I feel some pressure in my ears and the urge to swallow; is this also a result of the medication? Additional notes: (1) My job is software design.
(2) When the symptoms first appeared, I was sensitive to shaking objects (like a shaking desk on a non-concrete floor when someone walked by) and the wind shaking the windows, which caused palpitations.
(3) Recently, I seem to be more prone to absent-mindedness (after focusing on something, I find it easier to lose focus and need to remind myself to concentrate again).
(4) I am fighting against feelings of despair every day and am increasingly feeling exhausted! What should I do?

Xīnqíng, 40~49 year old female. Ask Date: 2005/02/23

Dr. Lai Lunxiang reply Neurology

Hello,
1.
The symptoms of head and body tremors are mostly caused by degeneration of the cerebellum or midbrain, but they are primarily seen in older adults.
Given your age, it seems unlikely (though early-onset forms do exist), so this aspect may require further examination.

2.
Additionally, considering the nature of your work, taking medications like Lexotan could be beneficial; however, this medication may not be suitable for you.
You might want to consider switching to another medication, as there are many options available in this category.

3.
I personally recommend that you engage in regular exercise, ensure you have enough leisure time, and avoid spending all day in front of the computer.
It's also important to stay well-hydrated.
I believe your symptoms may indicate excessive fatigue (to manage this, given your work, you can look online for appropriate strategies).

Reply Date: 2005/02/23

More Info

Understanding body and head tremors can be a complex issue, especially when they are accompanied by anxiety and emotional distress. Based on your description, it seems that you have been experiencing involuntary movements of your body and head, which can be quite distressing and may significantly impact your daily life. Let's break down the potential causes and management strategies for your symptoms.

Possible Causes
1. Anxiety and Stress: Your symptoms began after a significant event (the 921 earthquake), which could have triggered a prolonged state of anxiety. Anxiety can manifest physically in various ways, including tremors, muscle tension, and feelings of unease. The body’s response to stress can lead to muscle tightness, particularly in the neck and back, which may contribute to the sensations you are experiencing.

2. Medication Effects: You mentioned taking PTU for hyperthyroidism and later Lexotan (a benzodiazepine) for anxiety. While these medications can be effective, they also come with side effects, including drowsiness, muscle stiffness, and potential withdrawal symptoms when reduced or stopped. The feeling of "pushing" or "tremors" you describe could be related to the effects of these medications or their withdrawal.

3. Physical Health Factors: Elevated liver enzymes (SGPT) and other underlying health issues could also contribute to your symptoms. It’s essential to monitor these levels and discuss them with your healthcare provider, as they can affect your overall well-being.

4. Neurological Considerations: Although you have undergone extensive testing, it’s crucial to rule out any neurological conditions that could cause tremors or involuntary movements. Conditions like essential tremor or even post-traumatic stress disorder (PTSD) could manifest in similar ways.

Management Strategies
1. Consultation with Specialists: It may be beneficial to consult with a neurologist to further evaluate your symptoms. They can conduct specific tests to rule out neurological disorders and provide tailored treatment options.

2. Cognitive Behavioral Therapy (CBT): Since anxiety seems to play a significant role in your symptoms, engaging in CBT can help you develop coping strategies to manage anxiety and reduce the physical manifestations of stress. A therapist can guide you through techniques to address your fears and improve your emotional resilience.

3. Medication Management: Discuss with your healthcare provider the possibility of adjusting your medication regimen. If Lexotan is helping but causing side effects, there may be alternative medications or therapies that could be more suitable for you. It’s essential to have a plan for tapering off medications if that is your goal.

4. Physical Therapy: Engaging in physical therapy can help alleviate muscle stiffness and improve your overall physical condition. A physical therapist can provide exercises tailored to your needs, focusing on relaxation techniques and improving posture, which may help reduce the sensations you are experiencing.

5. Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as meditation, yoga, or deep-breathing exercises, can help manage anxiety and improve your emotional state. These practices can also help you become more aware of your body and reduce the perception of tremors.

6. Lifestyle Modifications: Ensure you are maintaining a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep. Reducing caffeine and alcohol intake can also help manage anxiety and improve overall well-being.

7. Support Groups: Connecting with others who experience similar symptoms can provide emotional support and practical advice. Support groups can be a valuable resource for sharing experiences and coping strategies.

Conclusion
Your symptoms of body and head tremors, along with emotional distress, are multifaceted and may require a comprehensive approach to management. It’s crucial to work closely with healthcare professionals to identify the underlying causes and develop an effective treatment plan. Remember, you are not alone in this, and there are resources available to help you navigate these challenges. Prioritize your mental and physical health, and don’t hesitate to seek help when needed.

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