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By comparison, people with Parkinsonâs disease typically experience a hand tremor when their muscles are at rest and see a reduction in the tremor when their muscles are in use. Shaky hands can also be caused by: 1  seizure. 2  overactive thyroid. 3  cerebellar disease. 4  Huntingtonâs disease.
Some of the possible common medical causes of Involuntary twitches in the hands may include: 1  Excessive caffeine intake or other caffeinated drink. 2  Excessive alcohol consumption, alcoholism, or alcohol withdrawal. 3  Stress. 4  Anxiety. 5  Fatigue. 6  Benign essential tremor. 7  Thyrotoxicosis. 8  Carbon dioxide narcosis.