[55M] Experiencing internal tremors and unsteady gait

Patient Description

A 55-year-old male has been experiencing moderate internal tremors, predominantly in the trunk, for the past three months. The tremors occur at rest and seem to improve when the patient moves around. For about a year, the patient has also been dealing with an unsteady gait, described as being pulled to one side, which occasionally results in bumping into objects. Additionally, the patient reports headaches on the left side at the base of the skull. There is a 20-year history of diabetes, currently managed with Metformin 1000 mg taken twice daily. No other medications are reported, and there is no known family history of neurological disorders. The patient does not consume alcohol and has not been exposed to recreational drugs or environmental toxins that could be related to the symptoms.

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Arora's Assessment

What might be happening

Based on your symptoms, some possible conditions include:

  • Parkinson's Disease: This is a progressive disorder of the nervous system that affects movement. It can cause tremors, stiffness or slowing of movement, and problems with balance. The tremors usually start in one limb, often your hand or fingers, and over time, Parkinson's disease may reduce your ability to move and slow your movement, making simple tasks difficult and time-consuming.

    • Treatment typically involves medications that increase the levels of dopamine in the brain, such as Levodopa.
  • Essential Tremor: This is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking, and can affect almost any part of your body, but the trembling occurs most often in your hands. It can worsen with movement and improve with rest.

    • Treatment can include medications like beta blockers or anti-seizure drugs, and in severe cases, surgery or focused ultrasound.
  • Multiple System Atrophy (MSA): This is a rare, degenerative neurological disorder affecting your body's involuntary (autonomic) functions, including blood pressure, heart rate, bladder function, and motor control. It can cause a combination of parkinsonism (slowness, rigidity, and tremor), cerebellar dysfunction (ataxia, or uncoordinated movements), and autonomic dysfunction.

    • There's no cure for MSA, so treatment involves managing symptoms. This can include medications to increase blood pressure, physical therapy to improve motor symptoms, and medications to manage parkinsonism.

Please note that these are just possibilities and not a definitive diagnosis. It's important to consult with a healthcare provider for an accurate diagnosis.

What you can do

Given your symptoms, it is important to seek medical attention. You should schedule an appointment with a neurologist, who specializes in disorders of the nervous system. They can perform a physical examination and may order tests such as a brain MRI or a DaTscan to help determine the cause of your symptoms.

What you should look out for

If you experience any of the following symptoms, seek immediate medical attention:

  • Sudden onset of severe headache
  • Sudden difficulty speaking or understanding speech
  • Sudden weakness or numbness on one side of your body
  • Sudden vision changes
  • Sudden loss of balance or coordination

Remember, while I strive to provide accurate information, I'm not a doctor and this advice is not a substitute for professional medical advice. Always seek the advice of your healthcare provider with any questions you may have regarding a medical condition.

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1 yr ago

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People Also Ask


What are internal tremors and how do they differ from external tremors?

Internal tremors are sensations of shaking felt inside the body, often without visible movement. They differ from external tremors, which are visible and involve involuntary shaking of body parts. Internal tremors can be associated with neurological conditions and may improve with movement.


How can diabetes affect neurological health and contribute to symptoms like tremors or unsteady gait?

Diabetes can affect neurological health by causing nerve damage, known as diabetic neuropathy. This can lead to symptoms like unsteady gait and tremors due to impaired nerve function. Managing blood sugar levels is crucial to prevent or slow the progression of neuropathy.


What are the common symptoms of Parkinson's Disease and how is it diagnosed?

Common symptoms of Parkinson's Disease include tremors, stiffness, slowness of movement, and balance problems. Diagnosis typically involves a neurological examination and may include imaging tests like a DaTscan to assess dopamine levels in the brain.


What lifestyle changes can help manage symptoms of neurological disorders like tremors and unsteady gait?

Lifestyle changes that can help manage symptoms include regular physical exercise to improve balance and coordination, a healthy diet to support overall health, stress management techniques, and physical therapy to enhance mobility and strength.


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