I have many of the same questions about tremors and twitching. The problem is that both are normal to a degree and they look similar to non medical folks. In truth, the journey for exploring these questions starts at the primary care doctor, which may very little about MND(s), especially, the initial presentation. A neuro doc on the other hand has seen ALS and Parkinsons enoungh times to spot it walking through the door. What I'm saying is that you might not get an answer on the internet that will give you comfort; you will need to see the Neuro.
For what's it's worth, I will say that I find it hard to believe that the only symptom you would have even in the early stages of Parkinsons would the pin rolling. Even calling it pin rolling might vague to someone that never saw. I work in nursing home and I see the disease daily and have the misfortune of seeing it progress. When I started to twitch my first thought was oh, *beep* I'm going to get Parkinsons or ALS. The pin rolling looks more like a fine-rough tremor that is constant unti they start moving the arm. WHen it progresses it seems to keep twitching even after they move there arm. The big thing it that there are mental changes with it because the twitching is caused by a disruption in normal brain chemistry. They seem to answer more slowly, move slowly, seem confused only simple issues, stare off into space and so on. And bear in mind these are younger people 50-60's with other problems so the onset of parkinsons is not confused with just being older.
A postural tremor is one you see holding your fingers or hand against gravity. It is the most common tremor you see with stress, anxiety, and excess caffeine. I get it and it bothers me. If you get a tremor while reaching for something or manipulating a small item it might be intention tremor, but again, tremors from anxiety might be very similar. In nursing school there was this one guy who would have the worst hand shakes you can imagine right before every test that seemed to go away afterwards. Having simialr problems we talked and he told me his hands shake a litle all the time. He held his fingers out and you could see a minor shake, but when his fingers were relaxed, you saw nothing.
If you are laying your hand on you lap and are seeing or feeling tremors, that might a reson for concern if they are constant while awake and seem to be getting progressively worse. If you are feeling little bursts that cause a fluttering feeling that is fasics and everyone on this site has them, some worse than others. Tremors seem to be a part of the disease. Many on this site are checking their hands while eating or doing the pencil test to see if it shakes in differnt positions. The stress of thinking you might have a MND disease makes you have the tremors. Having the tremors, makes you think it is getting worse or progressing into something else whch adds to the stress and feeds the tremors...its a vicious cycle...
No one really knows what BFS is. Is it a mental health disorder? Is it a mild non progressive from of MND, the motor juntion, the muslce itself? Non one is sure. Ativan seems to help more than anything, which makes me think it is a disease process of stress. Just like some immune systems fail and lend itself to cancer, there might a biological modality for stress to be cumulative. It builds up in certain people and manifests as neuromuscular.
I had a bad week with twitching and hand tremors, but also lots of stress. This morning It seems fine. I don't take any medications for my twitching. I take vitimins, but I think I will end up on the ativan train soon enough unless I can find a way to release the stress. If I figure it out, I;ll be sure to share with the forum