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trembling
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This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.

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trembling

background=3 months post partum, 31 years old, bilateral renal angiomyolipoma (nephrectomy feb 2010), no other clinical signs for tuberous sclerosis/no family history of tsc/genetic test couldnt id tsc/no seizures/visual exam doesnt show any skin signs of tsc/brain mri april 2009 was normal.  meds are prenatal vitamin (breastfeeding)/micronor (birthcontrol) and 20mg prozac (anxiety).  kidney function is normal with slightly elevated creatinine, no high bp.  

about 5 weeks ago i began having dizziness and nausea and began to experience trembling in my body.  had bloodwork done for thyroid and diabetes, tests came back normal.  i believe i also began having panic attacks at this time.  my obgyn rx'd prozac 10mg for 1 week then 20mg since (20mg three weeks now) for suspected anxiety/pp depression.  since starting the prozac i no longer tremble very much during the day but still experience it some while i sleep.  i never black out or pass out.  it's like a vibrating in my core and i have even felt it in my neck.  it lasts maybe 1 minute then stops.  i've been getting headaches now and then in the back left side of my head and once it felt like someone took an ice pick and stabbed the top of my head in one spot a few times.  my eyes feel tired and i'm having a hard time focusing sometimes.  i also sometimes feel like the lower left part of my spine is going "to sleep".  i went to the er friday night, the dr did a series of visual neuro tests, said didnt appear to be any type of emergency and i should follow up with my primary dr.  i'm sure this sounds crazy but i also notice that the problem seems worse at home.  is there any chance something in this house is causing these symptoms?  we have lived here for 7 months and i'm not sure why symptoms would have taken so long to show up and why my husband and children arent effected.  i also had an spinal epidural in feb 2010 and june 2010.  eye exam last week, dr said eyes look good.  any ideas?        
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Avatar_dr_m_tn
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to obtain a history from you and examine you, I can not comment on a formal diagnosis or treatment plan for your symptoms. However, I will try to provide you with some information regarding this matter.

Anxiety can cause the symptoms you are suffering. However, I do want to mention a few other causes for headaches in people with similar symptoms and history. But please, continue following up with your physician to sort out the underlying cause and your symptoms.

One cause for headaches and visual disturbances is a condition called pseudotumor cerebri. Pseudotumor, as it name implies, is a non-neoplastic (non-tumor) process that produces signs of an orbital tumor, e.g., proptosis (bulging of the eye) and/or papilledema (optic disc swelling) and/or ocular muscle palsy. It is also known as idiopathic intracranial hypertension. It is usually unilateral and the cause is usually not known. The papilledema, if left untreated, does represent a risk for permanent visual acuity reduction from atrophy of the optic nerve.  Because of this, it is recommended to have visual acuity testing performed at regular intervals. This can be done with a local optometrist. Clinical signs include headaches, nausea, vomiting, vision deficits, decreased eye movements, and worse with coughing or sneezing. It is diagnosed by having a brain scan to rule out other causes and a lumbar puncture (spinal tap) to measure the pressure of the fluid surrounding the spinal cord and brain. Treatment options include lumbar puncture to relieve the pressure surrounding the spinal cord and brain. This option may be repeated. Another option includes the medicine acetazolamide (diamox). In severe cases, ocular surgery (optic nerve sheath fenestration) or shunting may be required. This will need to be decided by a neuro-ophthalmologist or neurosurgeon. A neurologist can refer you if this is determined to be the source.

Another condition is post spinal tap headaches. This is secondary to intracranial hypotension (i.e., too little fluid around the brain). The headache improves when lying down but worsens with sitting up.

There are many causes of headaches and just as many headache types. Without further information about your headache, it is difficult to provide you with adequate information. However, it is important for you to understand that if you have not experienced headaches in the past and you are now having new head pains, seeing a neurologist is a good idea, just to make sure there is nothing serious causing this pain. Imaging of the brain and sometimes then neck may be indicated depending on your exact symptoms, your physical examination, and other factors.

Thank you for using the forum, I hope you find this information useful, good luck.
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