Have Tremors In Shoulders And Hands When Moving. Tests Normal. Could It Be Benign Fasciculation Syndrome?

Posted on Thu, 25 Jul 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 25 Jul 2013 Answered on

Tue, 20 Aug 2013 Last reviewed on

Question : For several months I have been having tremors that only manifest when I move. My shoulders seem to "ratchet" when shrugging. My hands only exhibit tremor when I am grasping something. I also have bilateral arm ache. I have been to several neurologists who have performed MRIs, Xrays, EMG and numerous blood tests. They have ruled out MS, ALS, and Parkinsons but have no diagnosis. I have found one disease that fits all my symptoms, Benign Fasciculation Syndrome. What are your thoughts. thanks

Answered by Dr. Hari Om Chandrakar (1 hour later)

Hello XXXXXXX

Thanks for your query.

The symptoms you had described was that you are having feeling of tremors when you want to grasp something,is known as Intentional tremors.

This symptom of intentional tremor is seen in damage or degradation of the cerebellum due to neuro-degenerative diseases, trauma, tumor, stroke, or toxicity.

But in your case it might be due to degenerative changes in your body, as other causes of tremors are ruled out by your neurologist.

As far as Benign Fasciculation Syndrome is concerned, the intentional movement of the involved muscle causes the fasciculations to cease immediately, but they may return once the muscle is at rest again, which is contradicting your symptoms.

The drug propranolol is a beta blocker drug, which reduces the tremors and anxiety related issues and the other drug is for hypertension.

Hope I have answered your query. If you have any further questions I will be happy to help.

Regards,
Dr XXXX

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Hari Om Chandrakar (1 hour later)

Are you sure about intentional tremor. I have no problem picking anything up or touching anything, no tremor there. It is only when I hold or grasp something, kind of like essential tremor. I can also induce the tremor in my hand by moving my wrist and at certain angles or arcs it will shake. No tremor at rest. the strangest thing is the ratcheting feeling in my shoulders when I shrug them and the BILATERAL arm aches. I also have fatigue which waxes and wanes. Sometimes the fatigue is extreme. I have had fasciculations in the past weeks but they seem to have gone. Again, all these symptoms line up with BFS.

Answered by Dr. Hari Om Chandrakar (4 hours later)

Hi,

Thanks for replying back.

The word intentional tremor is a finding, its not a name of disease.

There are many diseases found which differ slightly from books in someway or other, we cannot get perfect book like description of disease in a living human being.

All your symptoms direct to some degenerative problem either in brain or in peripheral nerve, which is age related.

For the confirmation of diagnosis you are advised to consult with a neurologist, as he can explain you in more detail about the disease and his views about disease, according to your sign and symptoms. As it requires thorough physical test and reflex tests and man other tests to be done to patient to get a proper diagnosis.

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T