Which Specialist Should I See for My Hand Tremors and Numbness?

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About two years ago, I experienced hand tremors that made it impossible for me to write properly, which lasted for 6 to 7 months.
The episodes disappeared, and I thought everything was fine.
However, this year my hands started shaking again, and I began to feel numbness in my left calf up to my knee.
When it gets severe, my leg shakes uncontrollably, making it difficult to walk.
About a week ago, I started experiencing numbness that began in my abdomen and spread upwards to my shoulders, left arm, left ear, left cheek, gums, and tongue.
This episode lasted about two and a half hours, and it was the first time I experienced such a long duration and wide range of symptoms.
During these episodes, I usually only feel numbness from my fingers to my elbows, and I cannot grip objects, causing them to drop.
Which specialty should I consult?

Anjing, 20~29 year old female. Ask Date: 2006/07/21

Dr. Cai Jueren reply Family Medicine

Hello, your issue seems to be related to a higher-level neurological problem, and I cannot address it in written form as it may cause you further distress.
Generally, a neurological examination should be prioritized.
If necessary, in addition to endocrine blood tests, a CT scan or MRI may be required.
I recommend visiting a neurology specialty outpatient clinic at a large hospital for a detailed examination.
Thank you for your inquiry.

Reply Date: 2006/07/21

More Info

Based on your symptoms of hand tremors, numbness, and the recent episodes of widespread tingling and weakness, it is crucial to seek a comprehensive evaluation from a specialist who can address these neurological concerns. Given the complexity of your symptoms, I recommend starting with a consultation with a neurologist. Neurologists specialize in disorders of the nervous system, which includes the brain, spinal cord, and peripheral nerves. They are well-equipped to diagnose conditions that may be causing your tremors and numbness.

During your visit, the neurologist will likely conduct a thorough clinical examination, which may include a detailed medical history, a physical examination, and possibly some diagnostic tests. These tests could include:
1. Electromyography (EMG) and Nerve Conduction Studies (NCS): These tests assess the electrical activity of your muscles and the speed of nerve conduction. They can help identify if there is nerve damage or dysfunction contributing to your symptoms.

2. Magnetic Resonance Imaging (MRI): An MRI of the brain and spinal cord can help rule out structural abnormalities, such as lesions, tumors, or other neurological conditions that could be causing your symptoms.

3. Blood Tests: These may be performed to check for metabolic or autoimmune conditions that could be affecting your nervous system.

4. Cerebrospinal Fluid Analysis: In some cases, a lumbar puncture may be performed to analyze the cerebrospinal fluid for signs of inflammation or infection.

Given the history of your symptoms, including the previous episodes of tremors and the recent onset of widespread numbness, it is essential to rule out conditions such as Multiple Sclerosis (MS), Peripheral Neuropathy, or even systemic issues like Vitamin B12 deficiency or thyroid dysfunction.
In addition to seeing a neurologist, if your symptoms are significantly affecting your daily life, you may also benefit from a multidisciplinary approach. This could include:
- Physical Therapy: A physical therapist can help you with exercises to improve strength and coordination, which may help manage tremors and improve function.

- Occupational Therapy: An occupational therapist can provide strategies and tools to help you perform daily activities more easily and safely.

- Psychiatric Evaluation: If anxiety or stress is contributing to your symptoms, a mental health professional may help you develop coping strategies.

It is important to address these symptoms promptly, as early intervention can lead to better outcomes. Make sure to keep a detailed record of your symptoms, including when they occur, their duration, and any potential triggers, as this information can be invaluable for your healthcare provider in making an accurate diagnosis.

In summary, start with a neurologist for a comprehensive evaluation of your hand tremors and numbness. Depending on the findings, you may be referred to other specialists or therapies to help manage your symptoms effectively. Remember, timely diagnosis and treatment are key to improving your quality of life.

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