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The Informed Parent

Uncontrollable Shaking

by Peter W. Welty, M.D., F.A.A.P.
Published on Aug. 12, 2013

Mrs. Gray was worried about her 14-year-old daughter. Last year she started a new private school. She and her husband work very hard in order to afford this school, and they want her to be able to succeed. But over the summer she has developed a shaking in her right hand. It has become so bad that she is anxious about attending the new school year. The shaking seems to go on all day long.

Upon examining the young girl, no physical problems were found. She was referred to a neurologist for more tests. She had the “million dollar” work-up, with all the blood work, X-rays and even an MRI. At the end they were told that the girl’s problems were not caused by any “medical “ condition. She had a “conversion” reaction, and needed counseling with a psychiatrist.

Conversion reactions are those where there are neurological symptoms, such as fainting or loss of sensation in a part of the body. It may present as seizure-like activity, or blindness where there is no physical cause discovered. It is felt that these problems are caused by stress or anxiety about an event in one’s life. A conversion reaction is the mind’s way of telling the body that it is “stressed out”. Often times there are changes in one’s life that need to be made in order to deal with these stressors more appropriately.

The doctor took great pains to assure that there was no medical reason for her symptoms. Roughly 25% of symptoms presenting as conversion symptoms eventually have a medical basis. There are other causes to consider. Is she consciously creating her symptoms? Is she depressed?

Mom may want to look at her daughter’s current life situation with her. Help her identify her stressors. Is her school too challenging for her? How is her social life? How has the school affected the home life and economic situation?   

Many times it is a good idea to have an objective third party, such as a therapist or psychiatrist. This person can help identify the various issues going on in the girl’s and family’s lives. They can also help her deal with her various anxieties more directly and more efficiently. Thus, her hand shaking will not be as necessary. A psychiatrist may also be able to offer a medication, if necessary.

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