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Dr. Andrew Rynne

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Unexplained Tremors. Normal EEG And MRI. Syncope. Any Answers?

I have unexplained severe tremors & have been to a neurologist to be tested for seizures where I was cleared for anything related to this. Everything was normal on EEG & MRI so nothing in the neuro department. Dr. suggested I see cardiologist as I have also had a couple of unexplained episodes of syncope . Not sure whether the two are related but both have happened while driving. One episode of syncope caused a traumatic car accident & I m thankful to walk away from it & no one was injured. Therefore, I m hoping you can provide me with some type of answer.
Mon, 18 Mar 2013
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Neurologist,  's  Response
Hi,

Thank you for posting your query.

Based on the symptoms, the two possible diagnoses are still seizures and syncope.

I should clarify that seizures are a clinical diagnosis and not purely based on the EEG and MRI findings.

EEG may be normal in about 50% of cases of seizures. MRI of brain may also be normal in many cases of seizures.

So, my suggestion would be to see a cardiologist to evaluate for syncope. If that is normal, then, an empirical course of anti epileptic drugs may be used.

Best wishes,
Dr Sudhir Kumar MD DM
Senior Consultant Neurologist
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Unexplained Tremors. Normal EEG And MRI. Syncope. Any Answers?

Hi, Thank you for posting your query. Based on the symptoms, the two possible diagnoses are still seizures and syncope. I should clarify that seizures are a clinical diagnosis and not purely based on the EEG and MRI findings. EEG may be normal in about 50% of cases of seizures. MRI of brain may also be normal in many cases of seizures. So, my suggestion would be to see a cardiologist to evaluate for syncope. If that is normal, then, an empirical course of anti epileptic drugs may be used. Best wishes, Dr Sudhir Kumar MD DM Senior Consultant Neurologist