resting tremor

[Joweeks]

We have exhausted many options with many different opinions. Over 4 years we have been to two local neurologists(Peoria,IL) Mayos(twice) and Iowa City recently. My wife is 43, with a terrible tremor affecting mainly left side now creeping into right. The tremor is worse with anxiety but prevalent all through the day. At night the tremor is completely gone. Four separate Neurologist have called it an anxiety induced tremor.  Psychiatrist have been treating this for 4 years with no success. Now a Iowa City Neurologist has finally called it Parkinsons. Started on Sinemet one weeks ago and was told we would have immediate results. Not only have we not seen results it seems to her to have gotten worse. Any ideas?

[Blessedsoulforever]

Hi,
It is suggestive of a condition called 'Essential Tremors'.
Essential tremor is the most common of the many movement disorders. It's far more common than Parkinson's disease, with which it may sometimes be confused. Unlike Parkinson's disease, however, essential tremor doesn't lead to serious complications. In fact, the word "essential" in essential tremor means the disorder isn't linked to other diseases.

For some people, essential tremor may be distressing but not debilitating. Others may find that their tremors make it difficult to work, perform everyday tasks that require fine-motor skills or do the things they enjoy. Severe tremors can lead to social withdrawal and isolation.
Fortunately, a variety of treatments exist that may help bring your tremors under control.
Most people with essential tremor don't need treatment beyond reassurance that the condition isn't a sign of a more serious disease. Lifestyle changes — which include getting plenty of rest and avoiding stressful situations and stimulants such as caffeine — may help ease the tremors. Most people with essential tremor find that fatigue, anxiety, sleep deprivation and even temperature extremes make their tremors worse.

If lifestyle changes don't help and tremors are keeping you from doing the things you enjoy, your doctor may recommend these options:

Medications provide relief from tremors roughly half the time. Medines like,
Beta blockers. Normally used to treat high blood pressure, beta blockers, such as propranolol (Inderal), help relieve tremors in some people. Because beta blockers are especially likely to cause dizziness, confusion and memory loss in older adults, they may be a better choice for younger people. They may not be an option if you also have asthma, diabetes or certain heart problems
.
Anti-seizure medications. These drugs, especially primidone (Mysoline), may be effective in people who don't respond to beta blockers. The main side effects are drowsiness and flu-like symptoms, which usually disappear within a short time.

Tranquilizers. Doctors sometimes use drugs such as diazepam (Valium) and alprazolam (Xanax) to treat people whose tremors are made much worse by tension or anxiety. Side effects can include confusion and memory loss. Additionally, these medications should be used with caution because they can be habit-forming.

Botulinum toxin type A (Botox) injections. You're probably familiar with Botox as a treatment for facial wrinkles, but it can also be useful in treating some types of tremors, especially of the head and voice. Botox injections can improve problems for up to three months at a time. When used to treat hand tremors, Botox can sometimes cause weakness in your fingers.

Surgery may be an option for people whose tremors are severely disabling and who don't respond to medications. Deep brain stimulation (DBS) is a treatment involving a brain implant device called a thalamic stimulator may be appropriate if you have severe tremors and if medications aren't effective. A pacemaker-like chest unit transmits electrical pulses through a wire to a lead implanted in your thalamus. The pulses, which are painless, may interrupt signals from your thalamus that help cause tremors. You turn the pulse generator on and off by passing a magnet over your chest.

Take a second opinion with a neurophysician.

Goodluck.