For the last six months or more I've developed an uncontrollable shaking in my right hand when I lift a glass or heavy object to my mouth. Recently the two middle fingers on my left hand tend to shake when I hold my hands out or while I'm typing this. I'm 67 years old, in generally good health.

Question

For the last six months or more I've developed an uncontrollable shaking in my right hand when I lift a glass or heavy object to my mouth. Recently the two middle fingers on my left hand tend to shake when I hold my hands out or while I'm typing this. I'm 67 years old, in generally good health.

Answer

What you describe is a neurological problem called a "tremor". Tremors can occur for various reasons. The type of tremor you describe could be an "intention tremor" that occurs with purposeful movement. Another type of tremor is called an "essential tremor" and can develop with aging and have no known cause. (In Parkinson's disease, the tremor occurs at rest.)

Intention tremors are usually due to some condition involving a part of the brain called the cerebellum, which is concerned with controlling movement and balance. Causes might be a stroke, chronic alcoholism, multiple sclerosis, or any of a number of less common neurological diseases. These tremors may be present in the resting state and worsen with activity (such as you describe while bringing your hand to the keyboard to type). These tremors usually comprise fairly broad movements that are typically slower than essential tremors.

Essential tremors are usually mild but become annoying while trying to perform simple tasks like cooking, writing, typing, or any other task involving fine use of your hands. This type of tremor can worsen with intake of stimulants such as caffeine and tobacco, certain medications for asthma or emphysema (such as theophylline), or excessive alcohol intake. They are not present in the resting state, unlike the intention tremors. They usually involve both sides of the body.

In any case, it would be a good idea for you to be seen soon by your primary care physician, who may refer you to a neurologist to make sure there is no damage to your cerebellum or any other area of the brain that connects to it. The tests will probably include a complete metabolic evaluation and some form of diagnostic imaging such as an MRI (magnetic resonance imaging) or CAT (computed axial tomography) scan of the brain. Be open with your doctor, especially regarding any lifestyle choices such as smoking, coffee/caffeine use, and alcohol intake. Also, don't be afraid to ask questions that address all your concerns so that you are fully aware of what is going on.