Why are your legs and hands shaking?

The condition, in which the legs and arms are shaking, is called in Latin medicine - a tremor, which literally means "trembling."

With such a phenomenon as the unconscious movements of the extremities (rhythmic, very frequent, with different amplitudes), a completely healthy person may encounter, for example, with strong excitement and fear, with unexpectedly occurring stressful situations or significant physical overloads. Neurologists do not consider this an anomaly, since the nature of such a short-lived tremor is physiological, and it usually passes with the disappearance of a provoking factor.

Therefore, we will consider only those cases when the legs and hands are shaking with this or that disease or pathology.

Causes of trembling legs and hands

Let's start with the simplest case, when the causes of trembling of the legs and hands (and often the whole body) are associated with chronic alcoholism, that is, a long poisoning of the body with ethyl alcohol. Why are hands and feet shaking with alcohol dependence? Because the active metabolite of ethanol, acetaldehyde causes oxidative stress of brain cells and their atrophy. Particularly affected by neurons and glial cells of the thalamus, hypothalamus and midbrain, as well as Purkinje cells in the cerebellum, which regulates muscle tone, movement and coordination.

A sufficient number of drugs (first of all, lithium preparations, neuroleptics, corticosteroids) in the list of possible side effects have involuntary trembling of limbs associated with temporary encephalopathy.

According to the classification of the main neurological disorders, the legs and hands are shaking most often due to the so-called essential (that is, without any external cause) tremor or Minor syndrome, a congenital pathology that descendants receive from ancestors with genes. And the head, lips, and trunk can shake, but most of all - hands.

As a rule, signs of this syndrome begin to appear after 40 years, although they can appear at any age. There are no other neurological symptoms, intellect and life expectancy are not decreasing. According to the American National Institute of Neurological Disorders and Stroke (NINDS), if parents have essential tremor, then the children's chance of developing the disorder is 50%.

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Causes of trembling legs and arms: encephalopathy

Encephalopathy is one of the key causes of hand and foot tremors after a stroke, head injuries, a brain tumor or a systemic disease such as multiple sclerosis. The most common and dangerous pathologies of the brain are associated with impaired cerebral circulation in atherosclerosis and arterial hypertension. Insufficient blood supply to the brain often leads to the development after 45-55 years of progressive chronic cerebrovascular insufficiency (dyscirculatory encephalopathy or chronic cerebral ischemia).

This pathology negatively affects the vascular system of the brain and the cellular metabolism of its tissues, affecting almost all of its structures and disrupting many functions. It is impossible to avoid the negative and the cerebellum (the role of which was discussed above); therefore, when the extrapyramidal system of the central nervous system is affected, patients complain that their legs and hands are shaking, the head is spinning, and there are problems with maintaining balance when walking.

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Causes of trembling legs and hands: hormones and neurotransmitters

Both hormones and neurotransmitters are biologically active substances of the human body, but they have a different principle of action. Without going into biochemical difficulties, we can define this difference in the following way: hormones enter the bloodstream and regulate metabolism and physiological processes, and neurotransmitters provide transmission of nerve impulses between neurons, in contact with the membranes of nerve cells.

Such a preamble is not accidental, since the causes of trembling of the legs and hands include such endocrine diseases as hyperthyroidism and diabetes mellitus. With increased activity of the thyroid gland, motor disorders are associated with a metabolic disorder: an overabundance of hormones of triiodothyronine and thyroxine reduces the synthesis of adrenaline, norepinephrine and dopamine, the main neurotransmitters, by the adrenal medulla. And the less of them, the more difficult is the transmission of nerve impulses in the central nervous system.

Why are hands and feet shaking with diabetes? Because the insufficient production of insulin by the pancreas leads to such a serious malfunction in the work of endocrine glands and disorders in the general metabolism that as a result various forms of diabetic neuropathy develop, including involving motor nerve fibers.

Finally, movement disorders in which the left arm and leg are shaking, or both right limbs (that is, on one side of the body) may indicate a trembling paralysis or Parkinson's disease, a neurological progressive disease that results from the death of brain neurons that produce dopamine. And the deficiency of this important neurotransmitter in the basal ganglia of the brain disrupts the work of the nigrostriatal conducting pathway, which provides the motor activity of the person.

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Symptoms of trembling legs and hands

With different pathologies, the symptoms of trembling legs and hands have both differences and similarities. So, with increased activity of the thyroid gland, fingers tremble (especially trembling, if the hands are raised and pulled forward), and this in neurology is diagnosed as a postural tremor (i.e., trembling in a certain posture). In addition, general weakness, tachycardia and dyspnea are noted. Signs of lowering blood sugar in diabetes - shake hands and legs and weakness, as well as hyperhidrosis (increased sweating). For such a case, the "litmus test" is eaten by the sweetness: if the limbs ceased to tremble, then the whole matter is in diabetes.

With alcoholism and Minor syndrome, the symptoms of trembling of the legs and hands correspond to the signs of cerebellar tremor that occurs in the final phase of any targeted movement (kinetic trembling) and is amplified by the slightest attempts to strain the muscles of the limbs. But in a state of rest, trembling passes. By the way, a similar symptom is noted when mercury vapor is poisoned.

In patients with Parkinson's disease, the symptoms of trembling of the legs and arms are very special and differ in that they are most pronounced at rest when the person is sitting or lying. But if he starts to produce some actions, how the trembling becomes less noticeable and can stop for a while. The trembling of the hands, characteristic of this disease, is similar to the movement of the fingers when counting coins. Parkinsonism is also characterized by a general reduction in active movements (hypokinesia) including facial motions; general stiffness and long stay in one position (numbness). The defeat of extrapyramidal system is expressed in a special parkinsonic gait: the feet are placed in parallel with each other, the movement is made by small shuffling steps - at first very slowly, and then with noticeable acceleration and inclination of the torso anteriorly.

Diagnosis of trembling of feet and hands

When performing the diagnostics of the trembling of the legs and hands, the neurologist relies on the patient's anamnesis (including family history) and examination with an assessment of: general and local motor activity, muscle weakness or atrophy, kinetic abnormalities in reflex movements, presence or absence of sensory loss or reduction of reflexes .

With Parkinson's disease, this is quite enough. In other cases, appropriate hardware and laboratory studies are assigned, and a specific pathology is determined based on the data: electrocardiogram (ECG), electroencephalogram (EEG), CT or MRI of the brain, electromyogram, cerebral ultrasound angiography, biochemical blood test, thyroid hormone levels in the blood (TSH), ultrasound of the thyroid gland.

Treating trembling legs and hands

In some cases, the treatment of trembling legs and hands is aimed at eliminating the causes of this symptom - whenever possible. And such an opportunity is available at the initial stages of chronic cerebrovascular insufficiency: regulation of blood pressure in patients with hypertensive hypotensive drugs, the use of antiarrhythmic drugs, etc. Therapy of this symptom in chronic cerebrovascular insufficiency is to maintain a sufficient level of cerebral circulation.

Ginkgo Biloba (Bilobil, Memoplant) is an antioxidant preparation of plant origin (capsules with Ginkgo Biloba leaves extract) - has a complex positive effect on many body systems, primarily on the vascular tone, on the general and cerebral blood flow, and on the synthesis of norepinephrine, serotonin and dopamine. With dyscirculatory encephalopathy, it is recommended to take the medication during meals (as follows with water) - one capsule 1-2 times a day; duration of application - up to three months.

To improve the cerebral blood flow continue to use drugs such as Piracetam (other trade names: Piramem, Cerebropan, Cyclocetam, Eumental, Gabacet, Piroxil, etc.) in capsules (0.4 grams) or tablets (0.2 g each) . This drug promotes the activation of cerebral circulation and redox processes in the brain, increases the synthesis of dopamine. This explains its use in both chronic cerebrovascular insufficiency and in parkinsonism of vascular etiology. Recommended dosage: 0.4 g three times a day (before eating); the maximum daily dose varies depending on the intensity of the tremor in the limbs, but should not exceed 4.8 g; the duration of treatment is from 1-1.5 months to 6 months, with a course repeat after 8 weeks.

Drug therapy for hyperthyroidism presupposes the appointment of a doctor-endocrinologist appropriate means, suppressing the production of hormones by the thyroid gland. Also, the treatment can be surgical and consists of thyroidectomy - the removal of the thyroid gland (partial or complete).

If the symptoms of essential tremor (congenital Minor Syndrome) are poorly expressed, no treatment is required. However, in domestic neurology, a 5% solution of pyridoxine (vitamin B6) is administered by intramuscular injection of 4-8 ml per day for 30 days, with a repeat injection twice a year.

Symptomatic treatment of trembling of the legs and hands is carried out with drugs of the beta-blocker group used in the therapy of hypertension, cardiac arrhythmia and myocardial infarction. Blocking the binding of epinephrine with other hormones, these drugs reduce their effect on beta-adrenoreceptors, reducing the body's response to stress. Most neurologists prescribe patients to receive Propranolol or Nadolol, as well as anticonvulsants, for example, Hexamidine.

Tableted propranolol (synonyms - Anaprilin, Inderal, Betadren, Dociton, Elanol, Naprinin, etc.) is recommended to take 20 mg twice (regardless of food). The duration of the course of therapy is determined by the doctor. Nadolone (Anabeth, Betadol, Solgol) is taken orally once a day for 40 mg. Both drugs have contraindications: bronchial asthma, propensity to bronchospasm, sinus bradycardia, pulmonary hypertension. During pregnancy and lactation, these medicines are categorically contraindicated.

Anticonvulsant Hexamidine (Primidone, Mizolin, Deoxyphenobarbiton, Prilepsin, etc.) is taken orally, the standard dose is 0.125 g in 1-2 doses; the maximum single dose - 0.75 g, daily - 2 g. This drug is contraindicated in the pathology of the kidneys, liver and hematopoiesis system; causes side effects in the form of dizziness, headache, drowsiness, rashes on the skin, reducing the level of red blood cells and leukocytes in the blood.

Treating trembling legs and hands in Parkinson's disease

When the legs and hands are shaking with an incurable Parkinson's disease, only symptomatic medication is performed using a variety of special preparations. One of them - Levodopa (Carbidopa, Levokom) - reduces the trembling with the appointment of a standard dose - half a tablet (125 mg) 1-2 times a day or a tablet (250 mg) per day or every other day (during meals). The use of this medication may be accompanied by a dystonic condition, dizziness, nausea, vomiting, impaired appetite and stool, problems with urination, dry mouth, abdominal pain, urticaria, drowsiness or insomnia, weakness, visual impairment, confusion, etc.

Relaxes motor disorders in patients with Parkinson's disease produced in tablets of 0.375 mg medication Pramipexol (Pramiprex, Miraksol, Mirapex), which slows down the destruction of dopaminergic neurons of the brain and has a stimulating effect on the receptors of this neurotransmitter. The recommended standard dose is one tablet (once a day); the dose can be increased by the attending physician every week (taking into account the manifestation of side effects) up to a maximum daily dose of 12 tablets (4.5 mg). However, the list of side effects of this remedy is extremely extensive, including sleep disorders, hallucinations, memory failures, depressive state with thoughts of suicide, decreased blood pressure, cardiac arrhythmias, shortness of breath, nasopharyngeal inflammation, gastrointestinal disturbances, painful sensations of various locations, and many others.

Cyclodol (Trihexyphenidyl, Parkopan, Parkinsan, Romparkin, Tremin, etc.) reduces the symptoms of trembling of the legs and hands due to its anticholinergic action. Neurologists prescribe this drug for Parkinson's disease and other pathologies of the extrapyramidal system. Tablets (0.001 g, 0.002 and 0.005 g) are taken after meals - 0.0005-0.001 g per day; the scheme of a gradual increase in dose is prescribed by the doctor up to a maximum daily dose of 0.02 g. Cyclodol is not used for glaucoma, indiscriminate atrial contraction, persistent increase in blood pressure and atherosclerosis. Possible side effects of the drug are dry mouth, ophthalmic disorders, increased heart rate.

Prevention of trembling of feet and hands

It is unlikely that the tremor of the legs and hands can be prevented with essential trembling syndrome, Parkinson's disease or multiple sclerosis, but with alcohol tremor it is necessary to quit drinking and undergo a course of detoxification of the body. Endocrine diseases associated with the thyroid and pancreas, as well as hypertension and atherosclerosis should be treated; Do not take your own "prescribed" drugs (to avoid side effects).

As the most common preventive measures for this pathology, doctors are advised to lead a healthy lifestyle. What this means in mind, you yourself know perfectly well: to eat well, avoid stress, exercise (it's best to swim), not to abuse alcohol and coffee. But Western neurologists believe that caffeine can prevent Parkinson's disease.

Considering that in most cases the therapeutic effect on the pathology, in which the legs and hands are shaking, is symptomatic, the cause of the disease, like the disease itself, remains most often. So the prognosis of trembling of the legs and hands can be formulated as follows: they do not die from this, they live with it, systematically taking medications prescribed by the doctor to reduce the intensity of the manifestation of the symptom.