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Thanks for posting the commentary about internal tremors, Judith. Considering how many neuros and other physicians (none movement disorder specialists, excepting for Dr. Iacono) I've seen - the few at my HMO and the many that Social Security has sent me to - NEVER seem to know what I mean when I say I have "internal tremors." They've never heard of it and across the board dismissed this very real and fairly common PD symptom as "just" being depression or a figment of my imagination. Mind you, I never gone to any MD specifically seeking relief for that one symptom as it's something I can live with. The only reason it gets mentioned in the first place is when I've been required to complete first-visit-paperwork and to list my current symptoms, surgeries, family history, etc. Then the MD (or the Social Security judge who is a lawyer, NOT an MD!) claims there's no such thing as an "internal tremor." AAAARGH! Sooooo... that said, I'm gonna print out a copy of your post and carry it around in my wallet JUST to be able to whip it out and SHOW those skeptics there really IS such a thing as an "internal tremor" for many PD suffers! Thanks again..... Barb Mallut [log in to unmask] ---------- From: Parkinson's Information Exchange on behalf of Judith Richards Sent: Thursday, January 01, 1998 10:22 AM To: Multiple recipients of list PARKINSN Subject: internal tremors In the article re internal tremors posted by Alan Bonander, the following paragraph has had me looking for the results of the study. "Further studies of the sensation of internal tremor are currently planned at the U. of Miami to aid in both better understanding and treatment of this previously undescribed symptom in Parkinson's disease." This is what I've been able to find so far ... Mov Disord 11: 3-7 (1996)[PMID8771060,MUID96366946] Internal tremor in patients with Parkinson's disease. L. M. Shulman, C. Singer, J. A. Bean & W. J. Weiner Department of Neurology, University of Miami School of Medicine, Florida 33136, USA. Although sensory symptoms were not originally described in Parkinson's disease (PD), in recent years it has been increasingly recognized that painful sensations and paresthesias occur in approximately 40% of patients. It has been our observation that PD patients often describe a sensation of internal tremor, a feeling of tremor inside the chest, abdomen, arms, or legs that cannot be seen. We investigated the prevalence and characteristics of internal tremor by administering a questionnaire to 100 consecutive patients with PD and 50 age-matched controls seen in our movement disorders center. A sensation of internal tremor was present in 44% of this sample of PD patients and in 6% of the control population (p < 0.0001). The presence of internal tremor was unrelated to Unified Parkinson's Disease Rating Scale score, Hoehn and Yahr stage, duration of disease, or the presence of observable tremor. The frequency of other sensory symptoms (aching, tingling, burning) was higher in the PD patients with internal tremor (73%) than in those without (45%; p = 0.005). Internal tremor is associated with anxiety in 64% of patients (p < 0.0001). It was described as uncomfortable and was unrelieved by antiparkinsonian medication in three quarters of patients. A sensation of internal tremor is commonly reported by PD patients and should be recognized as a useful diagnostic factor in PD. Judith Richards [log in to unmask]