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Neurology  (Expert Forum)
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tremors
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MedHelp Member's Question

tremors

by Philip, Nov 28, 1999 12:00AM
I am having tremors in both of my arms and legs. From time to time it is more severe in my right hand. But my tremors are intense in my left and right leg as well as my left arm. These tremors happen when I extend my arms or lift my foot from the floor. My doctor did an MRI and ruled out Parkins, Wilson disease.He also stated it that I did not have a brain tumor. He has me on Mysoline and I take 4 250 mlg a day. The medicine has not done anything as of yet I have been on this medicine for about 2 months. I was wondering if this could be Essential Tremors. The nurse at the Dr.'s office said no but I do not understand why I am having these tremors. Pleas pass along any info you can. This is a very embarassing problem.

Thanks Phil

P.S. I am 30 if that helps any.
Doctor's Answer

by CCF Neuro[P] MD, RPS, Nov 28, 1999 12:00AM
Dear Philip:



Sorry to hear that you have tremors.  The type of tremor that you speak about, tremor with muscle movement or in action, is called a action tremor.  Essential tremor is tremor at rest or when your muscles are relaxed.  Parkinson's tremor is usually a resting tremor that goes away with movement.  The differential is wide including unknown (sorry), medication, stroke (unlikely in your case), dystonia (also unlikely), degenerative disease of the basal ganglia or cerebellum, anxiety, toxins, etc.  However, if a general practioner diagnosed your tremor, it might actually not be a tremor but faciculations.  Difficult to tell you without a visual exam.  Give the medication a few more days, if no effect let your neurologist know.



Sincerely,



CCF Neuro MD
Member Comments (33)

by Paul, Nov 28, 1999 12:00AM
What is Lhermitte's sign? Is it present all the time or does it come and go? How do you check for it (standing? sitting?). When I bend my neck forward-sometimes I feel a twinge in my arch-not both only one and never standing. Only occassionally not all the time. Could this be it?

by CCF Neuro[P] MD, RPS, Dec 09, 1999 12:00AM
Dear Paul:



Lhermitt's sign is when you flex your neck and feel twinges or radiation of pain down your back and maybe into your thighs.  It is not radiated to your arches.



CCF Neuro MD

by Mark, Jan 02, 2000 12:00AM
My name is Mark and I'd like to ask a doctor about tremor.  I've been having these slight shakes mainly in my fingers which I notice mainly when I'm eating (using a fork and knife) or when I'm drinking when the glass approaches my mouth.  What bothers me most is that I feel so embarrased that my heart beat increases and the tremor increases.  I can't say that the shakes are large but at times there worse than usual.  I'm so embarrased about the situation that I hardly go out to eat with my girlfriend anymore and lately started to drink some alcohol to relieve the shakes. When i do go out to eat i'm constantly looking at other people to see if there looking at me. I'm not a drinker or smoker but I've been taking antihistamines for about 5 years (Claritine- Loratidine).  I've tried to quit them but its no use because a rash develops within a day.  My doctor told me that I'm atopic.  The rash is like hives and I know there caused by certain foods but its too hard to tell so I gave up. A patch test is no use my doctor told me. I went to another doctor for the tremor and she took some blood tests and found that my thyroxine levels were just near the upper limit. she didn't give me any medication except for propranolol for the tremor.  The propranolol helps a little but i'm not happy with having to take it and i don't.



I definetely need some help.



Thanks

by CCF Neuro[P] MD, RPS, Jan 03, 2000 12:00AM
Dear Mark:



Sounds like you have essential tremor.  Interestingly, up to 50% of essential tremor is inherited.  We do not understand it's etiology.  There are other medications besides the beta adrenergics.  You might want to try primidone (used at much lower doses than for seizure control), carbonic anhydrase inhibitors, and some recent studies suggest that dopamine agonists might work.  One thing that should be ruled out is Wilson's disease.  This might be the first manifestation of this disease.  A simple serum ceruloplasm and urine copper test will rule this out.  



Sincerely,



CCF Neuro MD

by Sharon, Jan 03, 2000 12:00AM
I have another question about tremors, when my hand is at rest or  hanging down it is ok.  When i hold up my hand while the arm is resting on an armrest, my hand and fingers shake.  It is mainly in my right hand, but has started recently in the left.  I first found it a couple of months ago, was just sitting there with a cigarette in my index and middle fingers.  My right hand has also gotten weaker.  I know I shouldn't smoke and am going to try to quit.  Do you know what could be causing this?



Thank you

by CCF Neuro[P] MD, RPS, Jan 03, 2000 12:00AM
Dear Sharon:



There are many reasons that could cause this, from essential tremor, vitamin deficiency, Parkinson's, Wilson's, drug withdrawal, medications, etc.  Over the internet, it is impossible to give you an idea without examining you and taking a good neurological history.



Sincerely,



CCF Neuro MD

by Sharon, Jan 03, 2000 12:00AM
Thanks for your quick answer doctor, I rally appreciate it.  Sorry, I asked an unappropriate question, I meant to say, what kind of tremor do you think it is.



Thank you so much.

by CCF Neuro[P] MD, RPS, Jan 05, 2000 12:00AM
Dear Sharon:



It might be an essential tremor.



CCF Neuro MD

by GARRY, Jan 21, 2000 12:00AM
My father has been diagnosed as having Benign Essential Tremors, i have been told that there is no cure for this. He is getting in a bad way with it, is there anything that i can tell him to try. I have also been told that there is a very good chance that i will get this aswell. Is there any help groups i can contact, thank you Garry.

by Gail Vergara, Jan 22, 2000 12:00AM
My husband has developed a tremor in his jaw and lip.  It is not constant and if I call his attention he can stop it.  What are the possibilities?

by Moya, Jan 23, 2000 12:00AM
dear doctors

the love of my life has been diagnosed with essential tremor a few years ago. he had the d.b.s. surgery which was a failure. he is on mysoline and inderol which does nothing . he can't feed himself. please, what about xanax or remerol or something new. his life was music and successfully until this. i need help to help him.

please respond

by CCF Neuro[P] MD, RPS, Jan 25, 2000 12:00AM
Dear Moya:



I am not sure what to tell you.  I would seek another opinion for a movement specialist.  Usually deep brain stimulation is the last resort when medications failes.  If this too has failed, then the options are likely very limited.  I wish I could tell you something different.  However, I would still see another movement specialist to see if there are medication options.



Sincerely,



CCF Neuro MD

by Benn on Sat 5/2/2000, Feb 05, 2000 12:00AM
I have an essential tremor