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Suggest Treatment For Severe Body Tremors

Posted on Thu, 13 Oct 2016

Question: Male, age 60 with tremors that started about a year ago but very mild (wife did not notice). Over the last month, tremors have turned into violent shaking spasms involving head and sometime full body. Spasms last for 10-15 minutes and usually a couple time per day. Doctor put me on Primidone - made spasms/tremors worse so is now weaning me off along with prescription of Valium-which does not seem to help.

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Some more details.

Detailed Answer:
Hi,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

I would like to know some more details about your symptoms-
1) Do you have tremors on one side or both sides?
2)Does these respond to propranalol?
3)Do you have thyroid disorder or any other comorbidity?
4)Did you undergo a brain MRI?Is it normal?
5)Do you have rigidity of limbs or slowness in activities?

I shall be glad to have you in follow up with details so that I can answer this well.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ajay Panwar (5 hours later)

Hello Dr. Panwar...answers are as follos:
1. both sides
2. never taken Propranalol
3. No
4. No - hoping my PCP will authorize/schedule this upcoming week along with blood work.
5. only when the full-bodyshaking and/or head spasms occur - I feel like I have run a marathon after these events and usually have a sore neck accompanied by headache. I do not lose consciousness.

Answered by Dr. Ajay Panwar (23 hours later)

Brief Answer:
Is it possible to upload a video clip?

Detailed Answer:
Hi,
Thanks for being in follow-up and providing further details.

Propranolol should also be tried in case,these symmetrical tremors are classified as essential tremors.In fact, it is usually tried in symmetrical tremors.

However,I am still not pretty clear about the pattern of movements.
Is it possible for you to make a short video clip of the movements and post it on the google drive(and share the drive link here).That will help me to understand this shakiness well.

Hope that helps.I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (33 hours later)

Good morning Dr,
I am still trying to figure out the video and will try to get you a clip. In the meantime I want to mention that these tremors occur intermittently throughout the day (not when sleeping) and range from slight head shaking to violent full body shaking where my head whips back and forth (left and right) uncontrollably. I am responsive during the entire episode and able to converse. These worse-case episodes can last anywhere from 5 minutes to 2 hours;s the shorter versions appear to be the worse ones. My BP during one of these is 135/75 and rises to 145/85 afterwards. Your help is greatly appreciated as I struggle to get into my regular doctor - I am told that appointments are 6 months behind and I really need answers. Thank you.

Answered by Dr. Ajay Panwar (29 hours later)

Brief Answer:
Propranolol should be tried.

Detailed Answer:
Hi,
Thanks for being in follow-up.

Of course,I shall be waiting for the video to be uploaded.Head shaking may be 'essential tremors'. Propranolol is another 1st line drug in addition to primidone and should be tried.
However, this is just a presumptive opinion based on history.I would be able to make a better interpretation after watching the video.

I shall be glad to have you in follow-up for further queries.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Prasad