Hand Jerking
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Forums > Neurology > Jerking and tremors in hand
Hi, I have written before about my problems with peripheral neuropathy (cause undiagnosed),ataxia, and weakness in my legs. I had noticed for some time now that my hand right hand jerks uncontrollable whenever I am just about to fall asleep. Lately, in addition to this, it has been jerking so hard that it awakes me from sleep sometime. Also I have noticed a slight tremor in the same hand if I am holding something (the phone,computer mouse, etc.) My husband says my head tremors slightly also sometimes. Could this have anything to do with the neuropathy. This hand and arm also have neuropathy (pins, needles, stocking sensation) with weakness. I have lupus, fibromyalgia, and "possible vascuilitis" - as per my doctor. Could the jerking and tremors have anything to do with any of the conditions I mentioned. I was not sure if it was my mind playing tricks or if this is something I should be concerned about. Again, thanks for your time.
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These new problems do not sound as if they are part of your origional clinical presentation, tremor of the head and hands is typically found in benign essential tremor, but other possibilities like Parkinsoms disease need to be excluded. The jerks as you fall off to sleep sound like a different phenomenon again, these may be myoclonic jerks, myoclonic jerks occurr in everyone as we fall asleep ,but inyour case this sounds too extreme to fit within the normal spectrum.
These are complex problems which are further complicated by your pre-existing neurological issues. I think you need to be assessed by a neurologist with a view to assessing the possibility of essential tremor and you may require an EEG or sleep study to see what is causing the jerks.
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Many conditions cause myoclonus, or involuntary muscle twitching. Hiccups are a mild form. People with epilepsy or Parkinson’s disease may have frequent, severe muscle spasms. Antiepileptic medications, sedatives and botulinum injections can ease myoclonic twitching and jerking.
Epilepsy Foundation. Myoclonic Seizures. (https://www.epilepsy.com/learn/types-seizures/myoclonic-seizures) Accessed 9/29/2020.
Merck Manual. Myoclonus. (https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/movement-disorders/myoclonus) Accessed 9/29/2020.
National Institute of Neurologic Disorders and Stroke. Myoclonus Fact Sheet. (https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Myoclonus-Fact-Sheet) Accessed 9/29/2020.
National Organization for Rare Diseases. General Myoclonus. (https://rarediseases.org/rare-diseases/general-myoclonus/) Accessed 9/29/2020.
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Myoclonus is the medical term for brief, involuntary muscle twitching or jerking. Myoclonus comes on suddenly. It’s not a disease but a sign of another condition.
People who experience myoclonic twitches or jerks have muscles that unexpectedly tighten or contract (positive myoclonus) or relax (negative myoclonus). Muscle twitches may occur in one hand, arm or leg, or the face. Sometimes, myoclonus involves many muscles at the same time.
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Everyone has involuntary muscle twitches. If you’ve ever had the hiccups , jumped from being startled or felt your body jerk as you drifted off to sleep, you’ve experienced myoclonus.
Experts classify myoclonus by the underlying cause. Types include:
A disturbance to the central nervous system (brain and spinal cord) most likely causes these involuntary muscle twitches. For unknown reasons, the central nervous system sends an electrical impulse to muscles. Rarely, myoclonus occurs after an injury to the peripheral nerves outside the central nervous system.
People with certain conditions are more prone to myoclonus. These conditions include:
Your healthcare provider may order one or more of these tests to determine the cause of myoclonus:
Treatments for myoclonus depend on the underlying cause. Most treatments help by reducing the frequency and severity of muscle twitches. Treatments include:
You should call your healthcare provider if you experience:
Everyone has occasional involuntary muscle twitches, or myoclonus. But for some people, muscle spasms become disruptive and even dangerous. Your healthcare provider can determine the cause of myoclonus. Medications can reduce the severity and frequency of myoclonic twitches and jerks.
Last reviewed by a Cleveland Clinic medical professional on 09/28/2020.
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Hand tremors can be temporary but it can also be from an overactive thyroid, a neurological problem, or even stroke, so it’s important to talk to your doctor.
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Use our free symptom checker to find out what's causing your tremors.
Use our free symptom checker to find out what's causing your tremors.
Tremors are involuntary muscle contractions that cause shaking movements. Tremor can lead to shaking hands, legs, head, and even a shaky voice. Different diseases, most notably, Parkinson’s disease, can cause hand tremor because they damage the parts of the brain that control movement. Other causes include an overactive thyroid, chronic alcohol use, or anxiety.
You may notice a hand tremor when you have trouble holding objects or you notice a change in handwriting—or when someone else notices the shaking movements.
Tremors can look different depending on the condition that causes it. These differences can often help diagnose the cause of the tremor.
Medication is the most common treatment, but injections, or surgeries may also help control shaking hands. In some cases, people don’t need treatment.
If your hands shake when you hold something, it may be an essential tremor. Some tremors are made worse by doing an activity, like holding a cup or using a fork. To determine the type of tremor, your doctor will ask about any difficulties you have with these tasks and may even have you replicate some of the movements. — Dr. Karen Hoerst
An enhanced physiological tremor is not a neurological disease, but caused by other things like muscle movement and blood flow. Most of the time, the tremor is not noticeable. But sometimes it can become more pronounced and visible.
Some common triggers are anxiety, caffeine use, alcohol withdrawal, overactive thyroid (hyperthyroidism), or certain medications, such as stimulants.
To diagnose physiological tremor, your doctor will ask you about the pattern of the tremor (when it appears and what it looks like) and your risk factors.
Treatment is usually fixing the underlying issue, such as reducing doses of medications, reducing caffeine use, or treating hyperthyroidism.
Essential tremor is the most common neurological cause of tremor. People with essential tremor of the hands often notice problems completing tasks, such as writing, pouring a cup of water, or playing an instrument. The symptoms may fluctuate with time and vary in severity, but they are usually mild when you are at rest.
Treatment varies based on how much the tremor bothers you. Some people have a very mild tremor that does not affect their day-to-day activities and they may not want to treat it. If the tremor is severe or it prevents you from performing daily activities, you may need treatment.
You can start with adaptive technology such as weighted utensils. Other treatments range from oral medications like propranolol to injections, such as Botox, which paralyzes muscles to stop tremors.
When tremor is severe, you may need surgery called deep brain stimulation (DBS).
Use our free symptom checker to find out what's causing your tremors.
Parkinson’s disease is a neurological disorder that causes significant problems with the movement or “motor” system because of a problem with a brain chemical called dopamine. Classic symptoms are tremor and shaking or trembling hands. Tremors worsen over time.
Unlike essential tremor, the tremor happens mostly when you are at rest. People with Parkinson’s disease have stiff, slow movements, balance problems, and are at risk of falls. The tremor can also affect the legs. Other symptoms of Parkinson’s include dementia, mood disorders like depression, psychosis, and hallucinations.
Parkinson’s is treated with a medication called levodopa, which increases the amount of dopamine in the brain. Physical therapy is also helpful to improve movement and balance. Your doctor may have you try adaptive technology, such as weighted utensils or gloves.
You may need medications to treat other symptoms, such as antidepressants for depression or stool softeners for constipation. Surgery, such as deep brain stimulation, can reduce the physical symptoms of Parkinson’s disease in some people.
Stroke can cause a specific type of tremor called rubral tremor. It may happen during a stroke and can persist after the stroke. Rubral tremor causes irregular, jerk-like movements of the arms or legs. It is often made worse with movement.
Stroke can also cause a different type of tremor called a cerebellar tremor, which tends to occur when our brain needs to coordinate a specific movement, such as reaching for an object. This happens because a part of the brain called the cerebellum, which controls coordination, is damaged.
If you have stroke symptoms and develop a sudden tremor, you should call 9-1-1.
Treatment includes medications to reverse the effects of a stroke (called tissue plasminogen activase or tPA). You may also be given medications such as aspirin or other blood thinners to prevent more strokes.
Treating tremor caused by a stroke includes a combination of medications, such as levodopa, the medication used for Parkinson’s disease, or certain anti-seizure medications. You may need surgery, such as deep brain stimulation.
Some medications can cause hand tremors. Stimulant-type medications like methylphenidate, used to treat ADHD, and thyroid replacement medication called levothyroxine, commonly cause tremors. So can medications for asthma and other breathing problems, like steroids and albuterol inhalers. — Dr. Hoerst
Other conditions that may cause shaking hands include:
Use our free symptom checker to find out what's causing your tremors.
Try to stop shaky hands by holding them in certain positions. Getting more sleep and reducing how much coffee you drink may also help. If these strategies don’t make a difference, talk with your doctor. — Dr. Hoerst
Most tremors are not an emergency, but if you have a tremor that starts abruptly (over the course of minutes to an hour) you may be having a stroke and you should call 911.
There is some evidence that doing meditation exercises may reduce tremors. Follow these relaxation exercises from the International Essential Tremor Foundation .
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