Hello shakey58,
This was a most interesting question to research! Since it is
impossible to diagnose you in this forum, please consider the
information contained in this answer as informational in nature. This
answer is not intended to diagnose, treat or replace sound medical
advice from a licensed physician.
Your first question, can a piece of shrapnel, located in the C3-C4
location of the spine, short circuit the nervous system, and cause
hand and arm tremors. I believe in the expression ?Never say Never?,
and while not probable, it is not impossible that a piece of shrapnel
could cause some nerve problems. The shrapnel may cause pressure on a
nerve, causing inflammation, which can interrupt or delay impulses in
the nervous system. If you compare the nervous system to an electrical
circuit, the answer would be no. Let?s use an electrical light switch
and a lamp. In a normal circuit, when the switch is turned on, the
current flows to the bulb in the lamp, and returns to the primary
source, completing a circuit, repeating until the light switch is
turned off. If there is a worn wire, causing the two wires in the
cable to the lamp to touch, they complete the circuit, and the current
never reaches the bulb. This is a short circuit.
In the body, messages are carried in a similar fashion, using the
brain?s basal ganglia system. When you touch the hot bulb in the lamp,
the sensory nerves in your fingers send a message to your brain that
the bulb is hot! The brain sends a message (impulse) to the nerves
that control your muscles, telling them to MOVE the fingers AWAY from
the bulb! The circuit is similar, but different. If THIS circuit were
?shorted?, you would be paralyzed! This circuit may be slowed from
inflammation or a partially crushed nerve. It is possible the shrapnel
splintered a piece of bone, or the shrapnel itself may be pressing on
a nerve, or cause tissue swelling around the nerve. Another
possibility is the shrapnel stimulated growth of osteophytes, small
bone spurs that narrow the canal in which the nerve passes, putting
pressure on the nerve.
?Another interesting connection probably related to basal ganglia
activity is the development of fine motor tremors when we become
anxious. When the basal ganglia are overactive we are more at risk
for increased muscle tone or tremors. In my practice I have often
prescribed the medication propranolol to calm the tremors musicians
get during a performance. Personally, when I lecture in front of an
audience I do not hold papers in my hands because the paper may start
to rattle or shake in response to any anxiety I might feel.
Increased muscle tension related to overactive basal ganglia activity
is often associated with headaches. I have noticed that a number of
people with resistant headaches have intense focal areas of increased
activity in the basal ganglia. This seems to occur with both muscle
contraction headaches (often described a pain in the back of the neck
or as a tight band around the forehead) and migraines (usually
one-sided pounding or throbbing headache which may be preceded by an
aura or warning phenomena). Interestingly, often anticonvulsant
medication such as Depakote or Tegretol, which decrease areas of
overactivity in the brain, has been found helpful in decreasing some
types of headaches.?
http://www.brainplace.com/bp/brainsystem/basal.asp
After intensive research however, it seems more likely however, that
the shrapnel is not the cause of your tremor.An ordinary X-ray should
show the proximity of the shrapnel to the area of the cervical nerves.
I?m glad to hear you have ruled out Parkinson?s Disease, Thyroid
disease, alcohol, heavy metals, and such. It sounds as if you have
developed an essential tremor.
There are over 20 known causes of tremor, but ?Essential tremor
affects approximately 5 million people in the United States. Incidence
is highest in people over the age of 60?
http://www.neurologychannel.com/tremor/
===============
Cervical Injury
===============
?Tremor is a rare manifestation after neck injury, and its
physiological mechanism has not been elucidated. We studied the
effects of torque loading and ischaemic nerve block on coarse postural
tremor in the right upper extremity, which had developed in
association with a C7?C8 radiculopathy after traumatic neck injury in
a 55 year old man.?
http://jnnp.bmjjournals.com/cgi/content/full/73/5/585
?Once a vertebra loses its ideal relationship with contiguous
structures (subluxation) and becomes fixed or restricted at some point
(fixation) in its normal range of motion, it's no longer competent to
fully participate in ideal coordinated spinal dynamics. The affected
area becomes the target for unusual stress, weight-bearing and
traumatic. In addition to the attending circulatory, neuromechanical,
and static changes in the involved area, there is disturbed reflex
activity that can manifest as changes in superficial and deep
reflexes, hyperkinesia, pupillary changes, excessive lacrimation,
tremors and spasms.?
http://www.chiro.org/rc_schafer/mono-22.htm
C3 c4 nerves
http://courses.umassmed.edu/mbb1/2003/Pd_ne/NE_Motor.cfm
=================
Causes of Tremor:
=================
?You can develop a tremor from fatigue, stress, anxiety, or even rage.
However, an ongoing tremor that is not associated with a change in
your emotional state may be a sign of an underlying medical condition
and should be evaluated. You may learn, as many do, that your tremors
are perfectly normal, but eliminating medical reasons for the shaking
is important.
It is especially important to have tremors evaluated if body parts
other than the hands are involved, like your tongue or head, or if you
have other types of involuntary movements other than shaking.
Essential tremor is common in older people. Essential tremor is rarely
present when the hands are not being used. It becomes most apparent
when the affected person is trying to do something, like reaching for
an object or writing. It is not caused by an underlying disease.
Another common type of tremor is called familial tremor which, as the
name implies, tend to run in families.
Both essential and familial tremors may be suppressed by drinking
alcohol. This is a useful fact for making the diagnosis, but alcohol
is not a desirable treatment.?
http://www.nlm.nih.gov/medlineplus/print/ency/article/003192.htm
?The development of a noticeable tremor should be evaluated by
doctors. Doctors can usually identify the type of tremor by its
characteristics. The type of tremor determines which procedures are
performed. For essential tremor, doctors ask what drugs are being used
and whether the person is experiencing anxiety or stress. Often, a
blood test to detect an overactive thyroid gland is performed. For a
resting tremor, a complete neurologic evaluation and other procedures
to check for Parkinson's disease are performed. For intention tremor,
an imaging procedure, such as computed tomography (CT) or magnetic
resonance imaging (MRI), is often performed to look for damage to the
brain. For flapping tremor, blood tests to evaluate liver and kidney
function are performed.
Usually, treatment for a tremor is not needed. Avoiding uncomfortable
positions can help. Objects should be grasped firmly but comfortably
and held close to the body.
For people with essential tremor, drinking alcohol in moderation may
reduce the tremor. However, heavy drinking or alcohol withdrawal can
make the tremor worse. If people with essential tremor have difficulty
using utensils or do work that requires steady hands, drugs may help.
A beta-blocker, such as propranolol, is most commonly prescribed. If
it does not help, primidone, an anticonvulsant, is often tried.?
http://www.merck.com/mmhe/print/sec06/ch091/ch091c.html
=======================
Tremor Classifications:
=======================
Physiological Tremor
This is a very-low-amplitude fine tremor (between 6 Hz and 12 Hz) that
is barely visible to the naked eye. It is present in every normal
individual during maintaining a posture or movement. Neurologic
examination results of patients with physiologic tremor are usually
normal.
Enhanced Physiologic Tremor
This is a high-frequency, low-amplitude, visible tremor that occurs
primarily when a specific posture is maintained. Drugs and toxins
induce this form of tremor. The suspected mechanism is mechanical
activation at the muscular level. Signs and symptoms of drug toxicity
or other side effects may or may not be present. Tremor symptoms may
improve after discontinuation of the causative agent.
Essential Tremor
Essential tremor is the most common form of all movement disorders.
Classical essential tremor is predominantly a postural- or action-type
tremor and usually patient has positive family history of tremor.
Drinking alcohol often reduces the tremor. Other associated symptoms
may include mild gait difficulty.
Cerebellar Tremor
Cerebellar tremor is a low-frequency (less than 4 Hz) intention tremor
that usually occurs unilaterally. Common causes are multiple
sclerosis, stroke, and cerebellar injury. Signs and symptoms of
cerebellar dysfunction may be present, including ataxia, dysmetria,
dysdiadokinesia and dysarthria.
Holmes' Tremor
The term Holmes' tremor or rubral tremor designates a combination of
rest, postural, and action tremors due to midbrain lesions in the
vicinity of the red nucleus.5 This type of tremor is irregular and
slow frequency (4.5 Hz). Signs of ataxia and weakness may be present.
Common causes include cerebrovascular accident and multiple sclerosis,
with a possible delay of 2 weeks to 2 years in tremor onset and
occurrence of lesions.
Drug-induced Tremor
Types of tremors induced by drugs include enhanced physiologic tremor,
rest tremor, and action tremor. Signs and symptoms of drug-induced
tremors depend on the drug used and on a patient's predisposition to
its side effects. Some drugs cause extrapyramidal side effects
manifesting as bradykinesia, rigidity, and tremor. Table 4 is a list
of drugs that may induce tremor, along with the types of tremors and
neurologic signs they produce.
Tremor Due to Systemic Disease
Tremor due to systemic disease usually occurs when the patient is
moving or assumes a specific position. Associated symptoms include
asterixis, mental status changes, and other signs of systemic illness.
Diseases such as thyrotoxicosis and hepatic failure as well as
delirium tremens and drug withdrawal are among the common causes.
Psychogenic Tremor
Psychogenic tremor may involve any part of the body, but it most
commonly affects the extremities. Usually, tremor onset is sudden and
begins with an unusual combination of postural, action, and resting
tremors. Psychogenic tremor decreases with distraction and is
associated with multiple other psychosomatic complaints.
Orthostatic Tremor
Orthostatic tremor is considered to be a variant of essential tremor.
This type of tremor occurs in the legs immediately on standing and is
relieved by sitting down. Orthostatic tremor is usually high frequency
(14 Hz to 18 Hz), and no other clinical signs and symptoms are
present.
http://www.clevelandclinicmeded.com/diseasemanagement/neurology/tremor/tremors1.htm
?It's called "essential" because in the past, it had no known cause.
It's not caused by another neurological condition or the side effect
of a medication. ET usually affects the hands, but it may also affect
the head and neck (causing shaking), face, jaw, tongue, voice (causing
a shaking or quivering sound), the trunk and, rarely, the legs and
feet. The tremor may be a rhythmic "back-and-forth" or "to-and-fro"
movement produced by involuntary (unintentional) contractions of the
muscle. Severity of the tremors can vary greatly from hour to hour and
day to day.?
http://www.essentialtremor.org/home_extras/essential_tremor.shtml
?Essential tremor usually develops gradually during middle age or
later in life. Symptoms may remain mild or increase in severity over
time. Stress, fatigue, anxiety, and hot or cold weather can worsen the
disorder. Severe tremor may cause difficulty performing activities of
daily living, such as:
媲rushing hair and teeth
廈olding a glass without spilling
感erforming self-care (e.g., getting dressed, shaving, putting on makeup)
愈sing eating utensils
慌riting and drawing
Tremor is usually more severe during fine motor activities such as
writing or threading a needle and does not occur during rest or sleep.
If it occurs in the voice box, speech will be affected.?
http://www.neurologychannel.com/tremor/
?Essential tremor is due to abnormal communication between certain
areas of the brain, including the cerebellum, thalamus and brain stem.
In the majority of people with ET, the tremor seems to be inherited as
an autosomal dominant trait. This means that each child of a parent
with ET has approximately a 50% chance of inheriting a gene that
causes ET. However, not everyone who inherits a gene develops
symptoms. Some people have ET and do not have a family history of
tremor, suggesting the possibility of other causes. Researchers have
already located two genes that predispose to ET and are currently
trying to locate others. However, at this time, there is no generic
test for ET. Identifying genes may allow scientists to find a cure.?
http://www.essentialtremor.org/information/faq.shtml
=================
Diagnosing Tremor
=================
A neurologist will need to perform a multi-faceted neurological exam.
You may already have had this done.
?The neurological examination is divided into several components, each
focusing on a different part of the nervous system:
搶ental status
搾ranial nerves
搶otor system
新ensory system
暗he deep tendon reflexes
搾oordination and the cerebellum
搽ait
The exam requires skill, patience, and intelligence on the part of the
physician, and cooperation from the patient. Incomplete or inaccurate
exams can lead to incorrect diagnoses.?
http://www.neurologychannel.com/neuroexam.shtml
======================
Other Causes of Tremor
======================
-Drugs
Antidepressants, especially tricyclics
Beta-agonists
Depakote
Dopamine
Lithium
Metoclopramide
Neuroleptics
Theophylline
Thyroid hormones
Withdrawal of drugs
-Metabolic
B-12 deficiency
Hyperthyroidism
Hyperparathyroidism
Hypocalcemia
Hyponatremia
Kidney disease
Liver disease
BiPolar disease
Dystonias
Fahr's Syndrome http://www.ninds.nih.gov/disorders/fahrs/fahrs.htm
Diabetes
Machado-Joseph Disease
Olivopontocerebellar Atrophy http://www.ninds.nih.gov/disorders/opca/opca.htm
Opsoclonus Myoclonus
Pelizaeus-Merzbacher Disease
Ramsay Hunt Syndrome Type 2 http://www.5mcc.com/Assets/SUMMARY/TP1095.html
Schilder's Disease http://www.ninds.nih.gov/disorders/schilders/schilders.htm
Social phobias
Charcot-Marie-Tooth Disease
http://www.ninds.nih.gov/disorders/charcot/detail_charcot.htm
-Toxic
Mercury
Alcohol
Arsenic
Caffeine
DDT
Lead
Nicotine
Toluene
Withdrawal of alcohol, cocaine
http://www.emedicine.com/neuro/topic129.htm
http://www.waterconserve.info/articles/reader.asp?linkid=11330
?Tremor, a rhythmic, involuntary, oscillatory movement of body parts,
is the most common movement disorder. Tremors are classified as rest
or action tremors. Rest tremor occurs when the affected body part is
completely supported against gravity. Action tremors are produced by
voluntary muscle contraction and are further divided into postural,
isometric, or kinetic tremors.? Your?s would not be a resting tremor,
as you have already had Parkinson?s ruled out.
http://www.aafp.org/afp/20031015/1545.html
Subluxation
?When spinal bones are not in their proper place, the openings between
them can narrow. The vertebrae can impinge on the nerves branching out
from these spaces. This is commonly, though inaccurately, known as a
"pinched nerve."
This interferes with the normal flow of energy along the nerve fibers.
Messages traveling along the nerves will be distorted. If the full,
normal energy flow cannot pass to and from the brain, some part of the
body will be adversely affected.
We do not understand the human body well enough to predict exactly
what effect a subluxation will have. The nervous system is far too
complex for that. But we do know that any change in the flow of nerve
energy has to result in an abnormal change in body function.
Sometimes, the fact that there is nerve interference becomes obvious.
We experience pain, soreness, irregularity, weakness, digestive
disturbances or other health imbalances.?
http://www.worldchiropracticalliance.org/consumer/subluxation.htm
See an animation of the spinal nerves:
http://www.echiropractic.net/what_is_a_subluxation.htm
Post Traumatic Stress Syndrome/Post Traumatic Stress Disorder and Agent Orange
?Regardless of the etiology, it is important to stress to both the
veteran and his family that PTSD is not a sign of weakness but a
natural response to an unnatural set of circumstances.
Trauma produces an autonomic sympathetic discharge, with initial
symptoms that may include an increase in heart rate, respiration,
sweating, muscle tension, vigilance, and overwhelming anxiety. These
acute symptoms can become chronic. Traumatic nightmares, which are
replicas of the event itself, tend to occur early in the sleep cycle
and are associated with gross body movements.
Psychological and/or physical trauma may also produce endogenous
opioid peptides, which have anxiolytic action and reduce aggression
and feelings of inadequacy. Thus, re-exposure to the traumatic event
or a situation similar to it may produce an endogenous opioid peptide
response, which results in a subjective sense of calmness or control.
This may explain why some patients with PTSD continuously seek out
situations that remind them of the trauma. When the traumatic stimulus
stops, there may be a subsequent reduction in endogenous opiates,
creating symptoms that mimic opiate withdrawal. These
symptoms-probably mediated by CNS noradrenergic hyperactivity-include
anxiety, irritability, hyper-alertness, insomnia, and startle
response.?
?Anxiety symptoms such as restlessness, nervousness, and tremor may be present.?
?A hospitals with mental health clinics have clinicians who are well
versed in the treatment of PTSD patients. In addition, referrals can
be made to veterans centers that have considerable experience in
intervening and treating veterans suffering from the disorder.
Although these centers are typically designed to assist Vietnam
veterans, they can redirect the referral.
Approaches to treatment include psychotherapy, drug therapy, or a
combination of the two. Most PCTs also offer family education,
multifamily therapy, PTSD education groups, stress management,
spirituality groups, and recreational therapy.
?VA hospitals with mental health clinics have clinicians who are well
versed in the treatment of PTSD patients. In addition, referrals can
be made to veterans centers that have considerable experience in
intervening and treating veterans suffering from the disorder.
Although these centers are typically designed to assist Vietnam
veterans, they can redirect the referral.
Approaches to treatment include psychotherapy, drug therapy, or a
combination of the two. Most PCTs also offer family education,
multifamily therapy, PTSD education groups, stress management,
spirituality groups, and recreational therapy.?
http://www.va.gov/oaa/pocketcard/geriadv.asp
?The current investigation has been designed to follow up an earlier
study, also conducted in collaboration with the VA, which identified a
cluster of symptoms found primarily in a group of veterans deployed in
the Gulf War. The cluster includes blurred vision, speech difficulty,
hand tremor and unsteadiness. Because that study's findings were based
solely on questionnaire data, it was determined that the findings
could best be investigated by a follow-up study based on physical
examinations.?
http://www.gulflink.osd.mil/news/na_gwu_18oct00.html
?Shorter has argued that the nature of medically unexplained syndromes
has itself changed, with a shift from apparently neurological symptoms
such as paralyses, tremors and fits to more ill-defined and subjective
symptoms such as fatigue, pain and depression?
http://bjp.rcpsych.org/cgi/content/full/182/2/158
?Post-traumatic stress disorder (PTSD) is a group of distressing
symptoms that sometimes occur following a frightening event. The
event, called a stressor, is any situation in which a person has been
physically injured, has been threatened with death or bodily injury,
or has witnessed the death or injury of someone else. By definition,
the trauma must cause a strong experience of intense fear, horror or
helplessness. Some psychological and physiological arousal seems to be
a key to developing this disorder.?
http://www.intelihealth.com/IH/ihtIH/WSIHW000/8271/8879.html
?Post Traumatic Stress Disorder (PTSD) is a Psychiatric syndrome
characterized by behaviors such as poor sleep, frequent nightmares,
?flashbacks? (a vivid reliving of traumatic events), intrusive
memories of said events, social isolation, difficult relationships at
home and work, problems relating to authority, hypervigilance, mood
swings and/or episodes of irrational or excessive anger. PTSD clients
also commonly have a foreshortened sense of survival and exhibit signs
of a hyperactive nervous system such as ?nervous tics,? tremors,
chronic motor restlessness, etc. [1][2] And, by definition, PTSD is
caused by exposure to a trauma that the individual finds severe or
overwhelming. Or is it??
http://www.selfhelpmagazine.com/articles/ptsd/ptsdgen.html
?During World War I, for instance, "epidemics" of traumatic neuroses
were thought to be caused by shell explosions that brought about brain
concussion and thus a tremor in the whole body. In Great Britain the
syndrome was called "shell shock" and was assessed as typical
traumatically conditioned neurosis - a war neurosis, but one with a
somatic anchorage. Increasingly, however, theorists such as Charcot
came to the conclusion that the cause for post-traumatic neurosis was
to be found in psychic conditions. In Germany, where many
psychiatrists labeled all psychogenic illness "hysteria," this caused
a great deal of confusion over nomenclature, as well as a negative
attitude toward "war neurotics." Some psychiatrists refused to use the
label, although they had no hesitation in recognizing the
psychogenesis of the condition.?
http://www.ncptsd.org/publications/rq/rqhtml/V2N3.html?printable=yes
?In 1979, 47 railroad workers were exposed to PCBs including dioxin in
Missouri when cleaning up a spillage from a damaged tank car that had
been filled with these chemicals. All were followed medically for six
years. Their initial complaints included fatigue and muscle aches. Two
committed suicide. Careful evaluations at Rush-Presbyterian Hospital,
in Chicago, confirmed peripheral neuropathies (in 96%), depression
(69%), tremors (78%), abnormal fatigue (91%), and muscle aches or
cramp (51%). Half had cognitive problems, including problems with
attention and concentration (50%) and slowed reaction times.?
http://www.organicconsumers.org/monsanto/agentorange032102.cfm
===============================
Understanding Cervical Anatomy
===============================
?The spinal roots for C2 exit the spinal column at the atlanto-axis.
The C3 roots exit between C2 and C3.?
?In summary, the spinal cord segment serve specific motor and sensory
regions of the body. The sensory regions are called dermatomes with
each segment of the spinal cord innervating a particularly area of
skin. The distribution of these dermatomes are relatively
straightforward except on the limbs. In the arms, the cervical
dermatomes C5 to T1 are arrayed from proximal radial (C5) to distal
(C6-8) and proximal medial (T1). In the legs, the L1 to L5 dermatomes
cover the front of the leg from proximal to distal while the sacral
dermatomes cover the back of the leg.
Differences between neurological and rehabilitation definitions of
spinal cord injury levels. Doctors use two different definitions for
spinal cord injury levels. Given the same neurological examination and
findings, neurologists and physiatrists may not assign the same spinal
cord injury level. In general, neurologists define the level of injury
as the first spinal segmental level that shows abnormal neurological
loss. Thus, for example, if a person has loss of biceps, the motor
level of the injury is often said to be C4. In contrast, physiatrists
or rehabilitation doctors tend to define level of injury as the lowest
spinal segmental level that is normal. Thus, if a patient has normal
C3 sensations and absent C4 sensation, a physiatrist would say the
sensory level is C3 whereas a neurologist or neurosurgeon would call
it a C4 injury level. Most orthopedic surgeons tend to refer to the
bony level of injury as the level of injury.?
?The most common cervical spinal injuries involve C4 or C5. Take, for
example, a person who has had a burst fracture of the C5 vertebral
body. A burst fracture usually indicates severe trauma to vertebral
body that typically injures the C6 spinal cord situated at the C5
vertebrae and also the C4 spinal roots that exits the spinal column
between the C4 and C5 vertebra. Such an injury should cause a loss of
sensations in C4 dermatome and weak deltoids (C4) due to injury to the
C4 roots. Due to edema (swelling of the spinal cord), the biceps (C5)
may be initially weak but should recover. The wrist extensors (C6),
however, should remain weak and sensation at and below C6 should be
severely compromised. A neurosurgeon or neurologist examining the
above patient usually would conclude that there is a burst fracture at
C5 from the x-rays, an initial sensory level at C4 (the first abnormal
sensory dermatome) and the partial loss of deltoids and biceps would
imply a motor level at C4 (the highest abnormal muscle level). Over
time, as the patient recovers the C4 roots and the C5 spinal cord,
both the sensory level and motor level should end up at C6. Such
recovery is often attributed to "root" recovery. On the other hand, a
physiatrist would conclude that the patient initially has a C3 sensory
level, a C4 motor level, and a C5 vertebral injury level. If the
patient recovers the C4 root and the C5 cord,?
http://www.travisroyfoundation.org/pages/resources-classifications.htm
?Working in tandem with the brain, the nervous system can be thought
of as the special wiring that relays information back and forth from a
centralized master computer. The spinal cord, which runs from the
brain down through the bony spinal column, contains thread-like nerves
that branch off to every part of the body. Sensory nerves carry
messages from the sense organs (eyes, ears, nose, tongue, and skin) to
the brain for processing. The brain then sends instructions in
response through other specialized nerves to the physical parts of the
body, such as the muscles, that can carry out its commands. Without
the direction of the nervous system, our muscles would be useless,
unable to move or coordinate their actions. We wouldn't be able to
smile, blink our eyes, or use our hands or legs in any capacity - we
wouldn't even be able to breathe.?
?The midbrain, located deeper within the brain's structure, acts as a
cellular switchboard, keeping the different areas of the brain
communicating with one another. This is necessary for the brain to
carry out its most complicated functions, because its simultaneous
commands require proper routing and coordination.?
http://kidshealth.org/parent/general/body_basics/brain_nervous_system.html
Nerves from the cervical spine travel to the upper chest and arms.
These nerves carry impulses/messages two ways, from the brain to the
body, and back again, creating sensations. When trauma occurs to these
nerves, one would have the symptoms of tingling, pain, numbness and
weakness of the arms and chest area. There is plenty of good
information on the cervical and entire sine on the following sites:
http://www.neckreference.com/anatomy.html
http://www.neckreference.com/symptoms.html
More about cervical spine disorders:
http://www.neckreference.com/causes-mechanical-radiculopathy.html
http://www.neckreference.com/causes-mechanical-myelopathy.html
?The SPINAL CORD is a bundle of nerves that takes messages from the
brain to the body. For example, those messages tell your hands to move
or your feet to walk when your brain wants them to. Any serious injury
to the spine, particularly to the neck area (CERVICAL SPINE), can
cause a permanent interruption in the messages from the brain to the
body.?
http://www.usla.org/PublicInfo/spinal_injury2.asp
Illustrations of spine and vertebrae
http://www.merck.com/mmhe/sec06/ch093/ch093a.html
http://www.merck.com/mmhe/sec06/ch076/ch076c.html#fg076_2
?Some spinal cord disorders originate outside the cord. They include
injuries, infections, blockage of the blood supply, and compression.
The spinal cord may be compressed by bone (as in cervical spondylosis
or a fracture), an accumulation of blood (hematoma), a tumor, a
localized collection of pus (abscess), or a ruptured or herniated
disk. Other spinal cord disorders originate within the cord. They
include fluid-filled cavities (syrinxes), acute transverse myelitis,
tumors, abscesses, bleeding (hemorrhage), and multiple sclerosis.?
http://www.merck.com/mmhe/sec06/ch093/ch093a.html
Shrapnel
**This page does mention shrapnel wounds as causing tremor.
**WARNING-This page contains disturbing images and descriptions.
http://dcc2.bumc.bu.edu/refugees/signs.htm
?The visible wounds were "only a few scratches in the head" plus the
impact of the shell concussion on his body. The concussion lead to a
life-long tremor of his neck owing to slight nerve damage to the
neck.?
http://freepages.genealogy.rootsweb.com/~brett/cmgc/rwm23.html
?"I had tremors, paranoia--the whole package," he said. "The
workaholic bit was a way to escape."
He landed in the Veterans Administration Hospital at Medford, Mass.,
and he hooked up with the Reverend Bill Mark, a therapist, and
sessions with a support group of Vietnam veterans, who helped Miller
on the road to recovery.?
http://www.mca-marines.org/Leatherneck/deweyarch.htm
Management and Therapy
Surgical Management
For patients with severe, disabling, medication-refractory essential
tremor, surgery is a reasonable treatment option. Surgical management
includes ablative therapy through stereotactic thalamotomy or chronic
thalamic deep brain stimulation. The ventral intermediate nucleus of
the thalamus is the best target for both ablative and deep brain
stimulation surgeries. Contraindications for surgical management of
essential tremor include unstable medical illnesses, swallowing
difficulty, and marked cognitive problems.
http://www.clevelandclinicmeded.com/diseasemanagement/neurology/tremor/tremors1.htm
Additional Information
======================
About PET scans (Scroll down to see images):
http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/C/CNS.html#SpinalCord
This site provides readers with a short questionnaire that may help in
diagnosing your tremor.
http://www.essentialtremor.org/information/survey.shtml
About the cervical spine:
http://www.neurosurgerytoday.org/what/patient_e/cervical.asp
New Spinal Surgery Techniques
http://www.neckreference.com/articles-minimal.html?mastbox=yep
http://www.neckreference.com/articles-expect.html
?Gunshot wounds remain a relatively frequent cause of nerve injury.
In the vast majority of situations, the missile or bullet does not
actually divide the nerve, but rather produces intraneural damage
secondary to shock, blast or cavitation effects. Other than the
obvious need to attend to general principles of open wound tissue
debridement, the management of a gunshot wound associated nerve injury
essentially follows the principles of management of any neuroma in
continuity. Using this approach in military practice, approximately
70% of Vietnam War casualties demonstrated spontaneous recovery of
function over several months. Hence, an expectant attitude towards
recovery is advised, but with careful clinical and
electrophysiological follow-up to offer exploration and possible nerve
repair for patients not exhibiting evidence of recovery over
approximately four months. With this approach, approximately 60% of
patients with civilian gunshot wounds to the brachial plexus required
nerve exploration, and many of them required nerve repair. A baseline
clinical examination is particularly important in the patient
sustaining missile wounds, as there is a somewhat higher incidence of
concomitant vascular injury with pseudoaneurysm formation. Such
patients exhibit progressive neurological loss and require urgent
angiography to establish the diagnosis, followed by prompt repair of
the aneurysm and/or expanding hematoma to prevent irreversible
neurological deficit.?
http://ots.utoronto.ca/users/howardg/nerveinjury.html
Chemical Exposure/Agent Orange (Dioxin)
http://members.aol.com/fibroworld/traumadoc.htm
?My husband is a vietnam vet and suffering from horrible neurological
problems some as a result of agent orange exposure we believe. He has
extreme skin sensitivity, tremors, he is wheelchair bound due to loss
of balance and cerebral problems. Doctors have not quite found an
exact diagnosis but call it parkinsonism or a neurological disorder
with parkinson syptoms. We are trying to get help from the VA and are
having problems. Are any of you or anyone you know suffering from
neurological problems such as these??
http://www.voy.com/14001/
?My husband is a vietnam vet. we got married 2 years after Nam. In the
30 years wehave been together I have watched him slowly go down hill.
He has tremors and has had for over 25 years, he has degenerative
joint desease rheumatoid arthritis COPD/Emphysema?
http://www.voy.com/14001/1542.html
?She recently died in January 2002. One week before her death she
complained of hallucinations. After complaining to her doctor he
acknowledged that it was due to the high dose of epilepsy medication
she was on reacting with other psychoactive drugs. She didn't have
epilepsy. Nor was she diagnosed with it. She had "essential tremors"
as they put it, and would not confirm that they and the grapefruit
size tumor in her stomach were caused by Agent Orange.
Although vast research links Dioxin with many forms of cancer
including stomach lesions, no treatment or advisement was given with
reference to Agent Orange based on the VA not confirming or denying
that this lethal ?Agent? was the cause of her health abnormalities.
After her death I immediately asked for an autopsy and was denied due
to lack of funds. In trying to have her buried traditionally at
Arlington National Cemetery I was refused based on achievements and
time served although at least the Purple Heart speaks for itself.?
?The American Journal of Psychiatry has reported three clinical
studies of patients who suffer from panic attacks as a result of
exposure to pesticides.
Panic attacks are a medically defined condition involving:
confusion, disorientation, cold sweats, palpitations of the heart,
difficulty breathing, tremors, fatigue, muscular cramps, and chest
tightness.
The panic attacks became debilitating. These attacks were
brought on by the organic solvents in pesticides and were not dose
related. These are examples of ecological illness, like an allergic
reaction, to the presence of exotic synthetic chemicals in the
environment. If exposure to synthetic chemicals increases, more
such medical problems must be anticipated.?
http://www.ibiblio.org/london/pesticide-education/faqs/pesticides.health-risks.info
?I served with C/2/75 from 80- 83. I am suffering from a dibilitating
neurological disorder (Multifocul motor neuropathy). It started while
I
was in the service (hand tremors/atrophy). I never did seek medical
treatment until three years ago, so I have no record of it begining
while I was in. I might pursue a service connected claim. If any
others from that time period that have any medical, or related
problems can
contact me, that would be or great help. Thanks!?
http://www.75thrra.com/news-view.cfm?id=179
http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2003;volume=51;issue=4;spage=507;epage=511;aulast=Bhatoe
DAV - Disabled American Veterans
If you believe you were exposed to Agent Orange (Dioxin), please
contact your local DAV, who can assist you (for free) in filing
paperwork necessary for benefits and necessary medical treatment. They
have helped numerous Viet Nam veterans with this matter.
http://www.dav.org/
The VA Agent Orange web site
http://www.vba.va.gov/bln/21/benefits/herbicide/
More About Tremor
http://www.ninds.nih.gov/disorders/tremor/tremor.htm
Assistive Devices:
http://www.essentialtremor.org/seeking_help/friedman.pdf
Migrating Bullet Excerpt
?In the great majority of cases of long-standing intrathoracic foreign
bodies, patients are asymptomatic. However, symptoms may occur years
later from the migration of the foreign body. We report on a
70-year-old patient who developed relapsing pneumonia due to
obstruction of a bronchial branch of the left apical group by a
migrating infantry bullet impacting 53 years ago. This was not
diagnosed until the second attack of pneumonia in 1998. The bullet
remains were removed bronchoscopically and the pneumonia resolved
completely without further complications.?
http://www.blackwell-synergy.com/links/doi/10.1046/j.1365-2796.1999.00477.x
?The longest recorded interval from the initial entry of a foreign
body to its clinical presentation is 62 years.. In that instance, the
culprit was a 9- � 10-mm piece of shrapnel presenting as an abscess of
the chest wall. Other late presentations include swelling of the lip
consequent to a piece of glass embedded there after a land mine
explosion 39 years earlier,biliary colic caused by a grenade splinter
migrating into the common bile duct 34 years after injury,a
choledochoduodenal fistula resulting from a migrating infantry bullet
32 years after injury,and a pectoralis muscle abscess brought about by
a retained swab 32 years after a shoulder repair.?
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=521789
Other Folk?s Experiences:
Essential tremor
http://www.essentialtremor.org/discus_adult/messages/5/16.html?1106426231
===========================================================================
I hope this has helped you out, Shakey. If you are a retired vet, with
Tri-Care insurance, I would urge you to make a neurologist?s
appointment at the closest military installation. If the base/post
does not have a PET or SECT scanner, they can refer you to a facility
that does have the necessary equipment. After reading about migrating
shrapnel, maybe you should consider having the shrapnel removed at
this point! If it IS causing the tremors, you will be relieved. If
not, you will know and can seek help from a new angle.
If you don?t have Tri-Care, you can make an appointment at the
closest VA hospital. Tell them you want to get to the root of this
matter and get some help. It sounds a bit like you received somewhat
inconsistent care at one time. Consider contacting the DAV for
assistance with Agent Orange benefits and medical care. I have seen
them help many vets with this issue. My own husband is a 100% disabled
Viet Nam vet (with tremors), but only a very small piece of shrapnel
in his wrist!), and we have always found the staff of our local VA
hospital to be friendly, supportive and very helpful.
If any part of my answer is unclear or not what you were seeking,
please request an Answer Clarification and wait for my reply, before
rating. This will allow me to assist you further, if possible. Good
luck to you, and thank you for serving!
Regards, Crabcakes
Search Terms
Foreign object lodged cervical spine
etiology arm hand tremors
etiology essential tremor
Essential tremor
metal shrapnel nervous system ?uranium
agent orange + tremor + viet nam
dioxin + tremor
cervical spine + removing shrapnel
shrapnel injuries
c3 + c4 + cervical spine + injuries
migrating shrapnel body |
