Lupus is a chronic autoimmune disease where the body’s immune system mistakenly attacks its own healthy tissues and organs, leading to widespread inflammation and diverse symptoms. Symptoms vary greatly among individuals. A common concern is the experience of shaking hands or other tremors. This article explores the potential connections between lupus and tremors.
Understanding Tremors
A tremor is an involuntary, rhythmic muscle contraction causing oscillating movements in one or more body parts. These movements most commonly affect the hands, but can also occur in the arms, legs, head, voice, or torso. Tremors are broadly categorized by when and how they occur, such as at rest or during voluntary movement.
Physiological tremor is a subtle, normal shaking that can become more noticeable due to factors like stress, fatigue, anxiety, or certain medications. Essential tremor is a distinct neurological condition characterized by visible, rhythmic shaking that worsens with action or when holding a posture. This type often affects the hands and arms bilaterally, and can involve the head or voice. A resting tremor typically occurs when the affected body part is at rest and improves with movement, commonly associated with conditions like Parkinson’s disease.
Lupus and Neurological Manifestations
Systemic lupus erythematosus (SLE) can affect the central nervous system, including the brain and spinal cord, leading to various neurological symptoms. When lupus impacts the brain, spinal cord, or nerves, it is termed neuropsychiatric systemic lupus erythematosus (NPSLE). Approximately 40% of individuals with lupus may experience NPSLE, which can manifest as headaches, cognitive changes, seizures, and tremors.
Lupus can directly cause tremors by the immune system attacking nervous system tissues. Autoantibodies, immune proteins targeting the body’s own cells, can cross into the brain and trigger inflammation. This inflammation or damage to brain tissue, including vasculitis (inflammation of blood vessels) or demyelination (damage to nerve fiber coverings), can disrupt normal neurological function, leading to involuntary movements like tremors.
Other Factors Contributing to Tremors in Lupus Patients
Beyond direct neurological involvement, several other factors can contribute to tremors in individuals with lupus. Medications commonly prescribed for lupus treatment are a frequent cause. Corticosteroids, such as prednisone, can induce muscle twitching and hand tremors, with some studies reporting this side effect in 20-25% of patients. Immunosuppressants like cyclosporine, tacrolimus, and mycophenolate mofetil, used to reduce immune system activity, are also known to cause tremors.
Co-existing medical conditions, common in lupus patients, can also lead to tremors. Thyroid dysfunction is one example; both an overactive thyroid (hyperthyroidism) and an underactive thyroid (hypothyroidism) can cause tremors. Hyperthyroidism includes tremors among its symptoms. Kidney problems, a serious complication of lupus, can lead to electrolyte imbalances that might indirectly affect muscle control and contribute to shakiness.
General physiological and psychological factors can also exacerbate or cause tremors. Severe fatigue, a prevalent symptom of lupus, can increase the visibility of physiological tremors. Anxiety and stress can also heighten tremors. Certain substances like caffeine and alcohol can make existing tremors more pronounced.
When to Consult a Healthcare Provider
Experiencing new or worsening tremors, especially for individuals with lupus, warrants medical evaluation. Consult a healthcare provider to determine the underlying cause. This is particularly true if tremors begin suddenly, are accompanied by changes in thinking or muscle weakness, or affect speech or gait.
An accurate diagnosis is important to differentiate between tremors directly caused by lupus activity, medication side effects, or other co-existing conditions. Discussing symptoms with a rheumatologist or primary care physician is the first step. They can then guide further diagnostic tests or refer to a neurologist for specialized assessment and management.