Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Second Opinion

Forum: Neurology Forum
Topic: AMYOTROPHIC LATERAL SCLEROSIS - ALS


I need help. I am scared. I am a 44 year old female with a child to raise. After 6 months of mild tremors in my right hand, I sought the help of a small town neurologist. Upon initial office examination, he preliminarily diagnosed me with Parkinsons & prescribed Amentadine. I am awaiting reults of blood tests which I believe included thyroid & some type of trace elements screen. I am scheduled for MRI 12/9. Should I proceed with the Amentadine & MRI before seeking a second opinion? Even though I live 5 hours away, I am intersted in coming to the Cleveland Clinic due to your fine reputation. Can and/or how do I self-refer?

Dear Patrice:

Not all tremor is Parkinson's Disease. There are several forms of tremor, one type is very characteristic of Parkinson's. The tremor occurs at rest, looks like your rolling pills between your thumb and forefinger. The tremor is usually only at rest and with action (movement of the arm or hand towards something)it goes away. There are several other features of Parkinson's, you might have a hard time getting out of a chair, or starting and stoping while walking. You might have some rigid movements that will "loosen" up as you move the muscle through a range of motion. If you are in anyway doubtful of the diagnosis, I would get a second opinion. I would get an opinion with someone who is familiar with Parkinson's. We have several excellent doctors in this area. You can call 1-800 CCF-care for information about an appointment. Usually, with such a large diagnosis that has life long implications, your insurance company will allow second opinions. Best of luck and I hope that your tremor is simply an
essential tremor.

Sincerely,

CCF Neuro[P] MD,RPS



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