Internal tremors and vibrations in long COVID: a cross-sectional study, 2023, Zhou, Iwasaki et al.

[Eleanor]

I've had internal tremors. I discovered that they were related to my cortisol level. My cortisol is high, but I have seen other people with low cortisol saying that it gives them tremors too.

I have constant internal tremors but my cortisol was normal when tested. all I can say for sure is they're worse when I've over-exerted and when I'm hungry.

 

[Eleanor]

Since internal tremor and vibration can be a clinical manifestation of a central nervous system (CNS) or peripheral nervous system (PNS) disease, it would have been mandatory to systematically screen all included patients for cerebrovascular diseases, epilepsy, movement disorders, cerebellar diseases, or neuropathies by means of cerebral MRI, EEG, nerve conduction studies (NCS), and cerebrospinal fluid (CSF) examinations, if applicable.

I'd love to get this guy into a conversation with the FND guys who insist that you mustn't test patients for anything at all because that will make them ill by suggesting their symptoms might be real.

 

[rvallee]

To the Editor,

We were interested to read the article by Zhou et al on a retrospective observational study comparing demographic and socioeconomic characteristics, prepandemic comorbidities and new-onset disease between patients with internal tremor and vibration as symptoms of Long COVID and patients with Long COVID but without internal tremor or vibration.1 It was found that 37% of patients with long-COVID reported internal tremor or vibration, that patients with internal tremor had lower quality of life (QoL) scores than patients without tremor, and had a higher rate of new-onset mast cell dysfunction.1 The study concluded that patients with long-term COVID who manifest with internal tremor and vibration have different conditions and symptoms and poorer health than patients without these symptoms.1 The study is excellent, but some points should be discussed.

...

To summarize, this interesting study has limitations that put the results and their interpretation into perspective. Addressing these limitations could strengthen the conclusions and corroborate the study's message. Patients with prolonged COVID manifesting with internal tremor and vibrations need a thorough and comprehensive diagnostic workup to avoid overlooking a CNS/PNS or psychiatric disorder as the cause of these symptoms.

Open access

Missing from this letter is the reasoning for why psychiatry has anything to do with this. They waved it off under "it cannot be excluded that at least in some cases these symptoms had no organic correlate, but were rather a long-term psychosomatic reaction to the SARS-CoV-2 infection", which is not something psychiatry can exclude either. Or confirm, since psychosomatic is strictly a "we don't have a better explanation" process anyway.

Plus we know for a fact that psychiatry is completely useless at this stuff and that it's massively overhyped. Could be because cows are farting more, if we're going with wild speculative stuff.

And then they point out that "therapeutic interventions to treat internal tremor and vibration were not reported", but there are no such interventions out there, certainly not from psychiatry, so I don't see the point in that comment. It's as if they understand nothing of the process of how treatments are developed. Which they must certainly do, making this all even more bizarre.

This is a difficult problem, but the infinite belief that psychiatry, which has never found actual causes or developed treatments for problems like this, is the answer only compounds the problem. In fact, has been the problem itself for a long time now.

This is all just the ancient application of reactionary thinking to medicine, with the profession stuck half-way in the modern age, which actually solves problems, and half-way stuck on ideas taken literally out of Antiquity. The lack of actual reasoning behind such comments never fails to amaze me. Religion used to be the answer to all of this, now it's reduced to a few imaginary processes somewhere, which no one has yet identified, but everyone is certain must exist, because otherwise they would have no actual solution and look very silly.

And look very silly it all does. Just because it reads at a grade school level doesn't change that.

 

[rvallee]

I'd love to get this guy into a conversation with the FND guys who insist that you mustn't test patients for anything at all because that will make them ill by suggesting their symptoms might be real.

We would need a third guy, who tests the "just right" things the "just right" way.

Well, not a guy, a little girl with blond hair, apparently. According to legend anyway. And some very civilized bears, for some reason.