Orthostatic leg tremors. Does anyone know anything about these uncontrollable leg tremors?

My husband got a wiggly leg from the mood-stabilizing drugs he got after his stroke. He was unable to sit down for more than a few minutes--every meal was interrupted by a few walks around the house or block. Even when he stood up, his leg jiggled. He was always in motion. He said walking made him feel better. Luckily, his happened only during the day and not at night, so he never kicked me in his sleep like people with true Restless Leg Syndrome do.

I suspect Ativan, Haldol, or Risperdal caused it, because he was on those drugs when he started getting fidgety in the hospital. The neurologist agreed that these are likely candidates. It took a bit over a year after he stopped all mood-stabilizing drugs for it to go away. For a while, he took a Parkinson's drug to help control the fidgetting.

This is what the advertisements mean by "Call your doctor if you experience uncontrollable muscle movements as these may become permanent."

Such a blessing to have stopped the pancreatic cancer! YAY!
And getting to move into a dream home! AWEsome!
Number of suggestions:
For starters, Mom might need to try a "medication vacation", or a "modified" one, since she's been on so many meds.
Many meds can cause effects you describe--sometimes alone, or sometimes in combination with others.
Docs often throw so many meds, often at elders, it's almost impossible to tell what might be contributing to any potential side effects of any or all of them together.
Talk with her Primary Provider about this.

She's got a HX of bipolar?
Lithium is standardly used, but it's not the only way.
Even though it's now dosed in smaller amounts than in the past, it still can have harsh, permanent adverse effects, including hypothyroid issues, as well as muscle hyper-contractions/spasms/shakes/in-coordination.
There's growing suspicion that those with sub-clinical, or "normal value tests", but with numerous hypothyroid signs & symptoms, may be contributory to many people developing overt bipolar & other psychiatric conditions which otherwise might remain sub-clinical or minor problems--as can malnutrition conditions. Chemicals in our environment can also block use of existing hormones, -all of them, not just the sex hormones; OR, some folks make plenty, but cannot convert T4 into the usable T3 form, etc.
Talk with a knowledgeable Doc about this--many are still fairly clueless--even endocrinologists, if they are not really working to keep up with new developments.

To avoid lithium & it's adverse effects as long as possible now days, Docs may start by trying a mild dose [like 25 mg.] of anti-seizure med [such as Lamotragine or others], ramping that up as needed towards a more clinical dose, to see if that might help keep the person on a more even-keel.
It often works well all by itself.
IF needed, they then may try adding an anti-depressant [like sertraline or others] to prevent deeper dips into the depressive side.

ALSO, anti-depressants & anti-seizure meds may work best taken in split doses over a 24-hr. period; those patients who often clear drugs out of their systems faster; or may do well on a low dose, but need that to keep up a usable blood level, may respond better to split doses of some meds.
This is something that lucid patients can better respond to, while helping the Doc adjust doses that work best for them--it's done in the V.A. system often.
Caution: automated pharmacy systems often balk at handing out greater numbers of lower dose pills to be given in divided doses....those systems often keep trying to make people take 1 large dose per day--which puts some patients on an emotional roller-coaster &/or can increase adverse effects.
Talk with her Doc about this.
You might print this out and take it along, as reference.

NOTEs:
==Tricyclics [such as Elavil] behave similarly to herbs like St. John's Wort;
Tricyclics can help a person sleep better--so Drug companies used to advise Docs to have the patients take those before bedtime, to help them sleep better.
St. John's Wort does a decent job lifting depression & can have fewer or less drastic side effects as the drug counterparts might, for many people trying those.
==SSRI's, like Prozac or Zoloft, for instance, may be best used in those patients who sleep fine.
When SSRI's came out, drug reps advised Docs to tell patients to take those in the morning, AND, that those might not serve poor sleepers as well as a Tricyclic--that the complication of the patient having worse mental breaks/behaviors could be increased if dosing a poor sleeper with SSRI's.
Drug reps evidently have stopped advising those caveats.

IF a person fasts, or starves for a period of time, the good Flora in their gut can dwindle to nearly nothing, & can then contribute to wasting or malnutrition until it is corrected.
It is pretty common.
Your Mom lost a lot of weight, &/or may not be digesting food well; there may be deficiencies of nutrients & co-factors in her body, for many reasons [antibiotic use, stress, medications, no appetite, poor levels of good gut floras, mineral deficiencies, B-vitamin deficiencies, loss of pancreatic function, loss of bile function, diminished stomach acid, etc.etc.].
Commonly, trace minerals as well as major minerals can be deficient, especially in those who lose much weight quickly, or have limited dietary intake, or poor absorption from numerous causes.
Low-key, nutritional things one might try, usually have FAR less adverse effects.

Magnesium &/or Potassium deficiencies usually cause or make worse, all kinds of muscle spasms, tremors, tics, charlie horses, etc. hyper-contractility of muscles, resting or standing up.
==Blood test for magnesium must be a "red blood cell assay".
==Blood test for potassium is from serum.

One of the easiest ways to supplement for minerals, is using kelp snacks [tasty for most folks], or, something like Mezotrace mineral powder, which can sprinkle on each meals' foods, where it disappears into the food, but helps make bland things tastier just a little. Mezotrace by itself, has no real flavor; it may absorb better when used with foods that are acidic, such as orange juice, vinegar-based salad dressings, etc..

Many meds kill off or inhibit the Probiotics in the gut, too. So does stress.
It is critical to have plenty Good Flora / Probiotics, for many reasons.
A healthy, broad range of Probiotics in the digestive tract helps digestion & absorption of nutrients, helps heal the gut, helps immune function, helps mental/emotional health [specifically, such as L.Rhamnosus helping decrease anxiety & depression; research continues on that] .
It needs enough per day, that it can do the job--simply eating yogurt cannot catch up fast enough or effective enough, if medical-level conditions exist--it takes more therapeutic amounts then.
These are available at Health food, GNC's, Vitamin World etc. types stores, often at most Grocery Stores, even--the key is to look for ones that have the most varieties of flora in them, and largest numbers.
Caution: Taking only one single form, such as acidophilus, by itself, is great for stopping diarrhea, but by itself, fails to resolve problems.
Taking one type of Bifidus by itself, can cause diarrhea; It really does require a broad spectrum of probiotics in great numbers, to help best when medical-levels of conditions exist.
Capsules can be opened and put in a bite of food to give the person, or, dissolved in a small portion of what they can drink--even a bit of Ensure or applesauce or mashed potatoes.
These might help your stress levels, too!

Some of these things might be helpful for yourself, too, maybe...talk with your Doc.
The tendency towards bipolar & related, can be genetically predisposed--but it does not have to ramp into flagrant manifestations, if a person takes care to get proper nutrition, enough bright daylight most days for long enough, & perhaps use judicious medication as needed.

The park across from your dream home sounds wonderful!
Take time to enjoy that view, or walk there if you can.
Play music that is soothing/pleasant--but not when it is competing with other noises.
I've used headphones while resting--combines both comforting things in one time period.

Please keep us posted on your progress!

dear mystical, you have a good, good heart. look back on your last year...you and your family have been through so much, with your mom's health, a move, your own health...let your doctor help you get to the bottom of things with your mom...after a tough year, I hope all will come together so you can enjoy your beautiful new place

Hello all. This is Mystical. I appreciate so much, all of your feedback to me on this topic. I cannot thank you all individually so I thank you as a whole bunch. I love that your hearts went out to me and my mom and I will look into all of your great insights and the web sites you offered me. My heart is bursting with gratitude. Thanks aagin. HUS all around. Mystical (Joyce)

P.S.S. Sorry for the multiple posts - I'm usually more organized. There's also a support group for people with orthostatic tremors: http://www.orthostatictremor.org/index.html They have a forum and good info. Might be helpful.

The first thing I'd do is have her list of meds reviewed by a pharmacist who specializes in geriatric pharmacy. You can find one at this site: http://www.ccgp.org/locate-a-CGP They can do a review of her meds to make sure they're not interfering with each other. I worked in a pharmacy after college and quickly learned docs just don't understand or pay attention to all of the ins and outs of medication interactions, particularly when there are multiple meds involved.

I googled orthostatic leg tremors and found Mayo Clinic's site. They say Clonazepam can be used to lessen the tremors and helps in about 30% of patients.

http://www.mayoclinic.org/medical-edge-newspaper-2010/feb-26a.html

You certainly can't make your mom change her life-long negative personality. When she gets negative, get away from her. That negativity permeates everything around it and will bring you down too. Good luck...

I just found a nice description of orthostatic tremor on Mayo's website. Mystical22, you don't mention having had diagnostic tests done. The Mayo site suggested testing the electrical activity in the legs for diagnosis, I believe it mentioned EMG.

Lots of things can cause tremor and unstable walking, becoming weak and deconditioned from illness can cause a person to be unstable when walking. My mother had a compressed disc in her back that caused her to have tremors in her legs when walking and several falls. How did you determine it to be orthostatic tremor?

Here is an excellent website for orthostatic tremors:

I'm so sorry both you and your mother are going through this. But you are SO VERY fortunate to still have your mother. Catching it that early was such a blessing, I'm just sorry she's now having to go through the problems such surgery causes, especially losing her pancreas which like has been stated above, results in becoming diabetic. Hopefully, low dose Metformin is working for her. It is by far the healthiest of the diabetes prescriptions on the market and seems to have the fewest side effects. Several of the diabetes medicines have bad side effects and Actos in particular is one I'd recommend running from if at all possible.

God bless YOU for caring for your Mom and your diligence in caring for her shows in the fact you caught her disease so early. Stay strong and don't forget to keep us informed. And, on those days where you're just overwhelmed, come on here and vent, we're all good listeners and we've been there, done that, and lived to tell the tale. We're with you!

I don't think uncontrolled leg tremor when walking described by the person who posted the question and restless leg syndrome are the same thing. RLS occurs during sleep and disrupts your sleep. I'm also a nurse. I've never heard of orthostatic but plan to google it.

I hope your new house is not THE house from "Amityville Horror" I just watched yesterday! Seriously though, I am amazed your mom is still alive. My husband too had a pancreatic sarcoma removed in the beginning stages, and although removing the distal portion of a pancreas does not result in diabetes, your mom's pancreas removal made this a certainty. I don't know all the drugs she is on, but as a nurse, I can tell you, restless leg syndrome, as it is called, is treatable. Talk to her doctor. Is she more depressed because of her physical condition or is she in her depressive cycle with her bipolar disorder? That needs to be assessed by a psychiatrist and her physical health (i.e. her heart health) will suffer because of depression, so get her help now. I keep very stable with lithium carbonate, the gold standard for bipolar disorder. Maybe if she isn't on it, she could try it. A lot of doctors these days want to prescribe newer meds, but lithium has always worked well. Best of health to you both, and we too are experiencing a new (to us) house in AZ. I call it my money pit!

Hello. It certainly is a blessing that your Mom is a cancer survivor of pancreatic cancer, one of the worst! It's wonderful that it was found in stage one. Another good thing, as you mentioned, is the 60 lbs she lost. It sounds as though she lives with you in the beautiful new home across from the lake and park, which are all motivations to help her out of the depression she's feeling at the loss of her independence. Her Dr. should be able to help figure out what medications may be causing her to have these leg tremors. Possibly a smaller dose would ease up on the condition? I know people who take meds for Restless Leg Syndrome, but every medication has a side effect of some kind, and if she's already taking a pile of meds, one would hesitate to add anything else. But maybe her meds should by "tweaked." She's probably on meds for manic/depressive disorder, diabetes, heart issues, and new ones associated w/ the pancreatic cancer? Too much stuff all mixed together can cause problems. I'd talk to her Dr. about this and see what could be cut down, or eliminated on a trial to see how she does with less. Sometimes doctors just prescribe one after the other of pharmaceuticals until the patient is all messed up, and has no clue what or why it's happening. Good luck on finding out what's causing this, and keep stressing to your Mom how lucky she is to be alive, enjoying all the beauty and freedoms that many cannot...ie: even get out of bed, or, as in the case of dementia, losing their minds and ability to even recognize or remember the beauty they see. It may or may not help, but it's worth the try. God bless you, too. Sounds like you're a good daughter!