Brief Answer:
Ah--- more demographic information to work with

Detailed Answer:
Well, look at this....we've got some demographic information to work with.

Now, that I know you are a 57 year young lady who is on primidone let me ask you for how long you've had the tremors and are you or have you ever been a smoker, had diabetes, hypertension, or high cholesterol?

Now, tell me about the tremors a bit.....do they get better or worse when you try and use your right hand for anything active such as eating, writing, putting on clothes? Is there any tremor on the left side? Does the Primidone actually work well? Fair? Really doesn't work...but you feel you have to take something so you do? :)

Did you start the primidone down at 25 mg. and then, escalate or did you start at 50mg and then, crank it up?

As I said in the other question these are all significant risk factors for the demyelinating lesions you are describing. However, what doesn't go with the imaging is the fact that you have tremors and hyperreflexia on the right side. Now, another questions which is who or what type of physician prescribed the primidone and was it prescribed after having tried other medication such as either propranolol, metoprolol, or gabapentin? Please give me details of the hyperreflexia..in other words, can you describe what it's like? Is it strictly in the upper extremity on the right or also the lower?

Do you have neck pain of any sort? If so, is it primarily right sided and how long have you had such pain if in fact, it exists?

See how many questions I can suddenly generate which help to focus this pathology when all you do is provide a gender, age, and some preliminary information on whether or not you've visited a doctor and what medication you're on! HAHA!

Was the MRI done of your brain with or without gadolinium? Again, if you can get a copy of the report and upload it so I can read it then, you may provide me with more complete information.

Another cause of diffuse demyelination as is present in your scan is hypothyroidism and well as hypoadrenalism which suggests a reduction in cortisol which has a myriad of functions in the body.

As in the other case I wrote up for you-- I'd appreciate a STAR RATING and some brief written feedback if your questions have been satisfactorily answered. In addition, CLOSING THE QUERY on your end will also be most helpful as well as help other doctors use the information I've provided in this case for other patients with similar pictures.

Don't forget that my webpage to keep me abreast as to how you're doing is:

bit.ly/drdariushsaghafi

All the Best

This query has required a total of 14 minutes of physician specific time to read, research, and compile the return to the patient.

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