Movement Disorders: Why do my hands shake?

Movement disorders can be debilitating and significantly impact one’s quality of life. An accurate diagnosis and treatment by a neurologist who specializes in these often challenging and complex disorders is key.

What is a movement disorder?
Dr. Czarkowska: The term “movement disorder” refers to a brain problem that causes abnormal increased, reduced or slow movements. It can cause your limbs to become stiff and slow or shake, or cause your muscles to contract when you don’t want them to.

Should I be concerned that my hands shake?
Dr. Mikell: There are some people whose hands shake a little and it doesn’t get in the way of their ability to do the things they want to do. And there are others whose hands shake so much that they’ve stopped trying to do things like eat soup with a spoon, handwrite letters to loved ones or drink from a cup. If that’s you, you have a problem that should be evaluated by a neurologist who is knowledgeable about movement disorders, because treatment is available.

Are there many types of movement disorders?
Dr. Czarkowska: Yes. Some of the better known movement disorders include:
• Parkinson’s disease and other related disorders, which can cause the limbs to shake when the body is at rest, cause stiffness and slowness of movements and impair balance. These symptoms can make it difficult to walk and engage in daily activities.
• Essential tremor, which causes a person’s arms to shake rhythmically when the arms are being used to perform a function.
• Dystonia, which causes involuntary twisting or turning movements. These can involve neck muscles, causing the neck to turn in different ways (i.e., cervical dystonia). Other forms of dystonia can cause writer’s cramp, exaggerated blinking or involuntary jaw and mouth movements.
• Huntington’s disease, which causes uncontrolled movement of one’s arms, legs, head, face and upper body. It can also cause impaired cognitive abilities and psychiatric conditions.

How are you diagnosed?
Dr. Czarkowska: The first step is to undergo an evaluation by a movement disorders neurologist who is trained to diagnose and treat these complex disorders. At Stony Brook, when we meet a person for an initial evaluation, we ask them to perform different tasks like writing, walking across the room, pouring and drinking water and drawing spirals. From these seemingly simple tasks, we’re able to carefully observe nuances in their movements and make a diagnosis.

What treatments are available?
Dr. Mikell: Treatments can range from physical therapy and rehabilitation to botulinum toxin injection and even brain surgery. The treatment depends on establishing an accurate diagnosis. Anyone who is on medication and still suffering from bothersome symptoms of movement disorders is a candidate for deep brain stimulation (DBS) surgery. It involves placing small wires into the brain and stimulating them with electrical current. This safe and effective procedure gives patients increased mobility, use of their hands and greater independence. Many with Parkinson’s disease and tremor can benefit from DBS.

Why come to Stony Brook?
Dr. Czarkowska: Our expertise is sought out by neurologists across Long Island. Our team includes neurologists; neurosurgeons; psychiatrists; neuropsychologists; a social worker; and physical, occupational and speech therapists — all of whom specialize in movement disorders. For example, when a patient experiences challenges behaviorally, cognitively and emotionally that don’t go away after surgery or other medical treatment, we can provide a referral to one of our neuropsychologists who will provide a comprehensive evaluation and make recommendations that are applicable in all major areas of a person’s life.

To schedule an appointment with Dr. Czarkowska, call (631) 444-2599. To schedule an appointment with Dr. Mikell, call (631) 444-1213.

PARKINSON'S AND MOVEMENT DISORDERS SUPPORT GROUP
Open to all patients, family members and caregivers. Three locations: Commack, East Setauket and Southampton. For upcoming dates & locations visit: bit.ly/pmdsupport