Is the shaking in my mother's arm caused by the stroke she had?

Ajh1973 asked...

My mother had a stroke 5 weeks ago. The stroke was on the right side of the brain. She is very weak in the left side of her body but does not have any paralysis. However her arm and hand has started shaking uncontrollably at times. Is this caused from the stroke and is it normal?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

A few things come to mind that might explain the arm shaking:

1) Partial Seizure. This can occur as a result of scarring in the brain from the stroke. It is not too uncommon after a stroke, and would be associated with a convulsive motion of the arm with possible spread into the leg and face. If severe, it could cause loss of consciousness.

2) "Clonus" from increased muscle tone. This results from the spinal cord taking over muscle movements when the brain is providing insufficient input to control the arm. It results in a back and forth motion and can be quite painful.

3) "Limb Shaking TIA" from poor blood flow to the part of the brain controlling arm movements.

Of all the above possibilities, partial seizure would seem to me to be the most likely. I would have your doctor evaluate the above possibilities with an EEG and imaging of the arteries of the brain and neck (I am assuming here that imaging of the brain has already been completed). All of the above can be treated with medication, but an underlying cause should be sought first.

Good luck!