Undiagnosable debilitating neurological condition

  I am a 52 yr old professional male who appears outwardly healthy.  I exercise regularly and am in great physical shape for my age.  However, I have suffered from an unknown neurological condition for the past 11 years.  Many doctors have seen me but none have been able to diagnose the problem.  Here are the three major symptoms:
  1) Mental or "brain fog" which intensifies with visual concentration or talking
  2) Sleep disturbance (no problem falling asleep but wake up 2 to 3 hrs later and have great difficulty falling back asleep).  
  3) Two kinds of tremor: a fine tremor, which makes intricate movements difficult, and a more coarse, ratchetlike tremor which occurs when any muscle is stressed or flexed.  This affects the entire body.
  Some of the things which have been ruled out are lyme disease, depression, parkinson's, ALS, MS, Alzheimers, and chronic fatigue.  A controlled sleep study revealed that I get no stage 3 and stage 4 sleep.  Neurotransmitter levels are all extremely low, but these may not be accurate because they are based on blood samples and may not represent levels in the brain.  In 1988 the antidepressant Trazadone (Desyrel) produced some relief of the brain fog for a 4 month period, but subsequent adminstration of the same drug, as well as Prozac, Effexor, and Cerazone have yielded no results.  Small doses of Klonopin have had small positive effects.
  The condition has recently intensified and I am in great distress.  
  Has anyone else experienced symptoms similar to the above?  Please reply or email ***@****.  Thank you.

[CCF Neuro[P] MD RPS]

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Dear Gary:
Sorry for the long delay.  Without examining you and getting a detailed history it is difficult to give you an accurate diagnosis.  From what you tell me, the lack of stage III and IV sleep or also known as deep sleep, many of the problems you describe could be accentuated by not getting the correct type of sleep.  We need deep sleep to perform throughout the waking period.  When our sleep is disrupted, we have difficulty concentrating, morning headaches, impotence, etc.  I would imagine that you are tired throughout the day, probably need cat naps or fall asleep while listening to boring people at long meetings.  I would suggest seeing a sleep expert. I'm not sure about the tremor, but stress can make a condition known as essential tremor worse.  The lack of proper sleep is definitely a stressor.
Let us know how things turn out.  Again, sorry for the delay.
Sincerely,
CCF Neuro[P] MD