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Suggest Medication For Essential Tremors
Question: i have Familial Tremor, Microvascular Heart Disease and Fibromyalgia. the most troubling symptoms are the tremor which has recently gotten more pronounced and also very poor balance. I keep falling. My doctor did the DAT test and has ruled out Parkinsons. I am wondering if it is Ataxia. I used to be very coordinated==played tennis etc. Now my arms/hands don't work--I am constantly dropping or spilling things. My husband is concerned about the faling and spilling and I don't know what to tell him. I've been to a few Neurologists and they don't have any answers or suggestions.
I have been taken Klonopin for several years. It does help somewhat. In addition. the doctor prescribed Vitamin B-12--first the tablets then the shots for about 9 months. I don't notice any lessening of symptoms.
I have been taken Klonopin for several years. It does help somewhat. In addition. the doctor prescribed Vitamin B-12--first the tablets then the shots for about 9 months. I don't notice any lessening of symptoms.
Brief Answer:
I would recommend as follows :
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to have some more information on your tremor.
Is it a resting tremor or it is more prominent during intentional physical activity (holding the spoon, the cup of coffee, etc)?
Have you tried taking alcohol (a glass of wine, etc) does it relief your tremor?
Based on your DAT scan a parkinson disease can truly be excluded.
But some degenerative disorders affecting the small brain (cerebellum) can not be excluded.
A thyroid dysfunction could also mimic this clinical scenario.
I recommend performing thyroid hormone levels to rule in / out this possibility.
Have you tried any medications?
If alcohol relieves your tremor, this would be very indicative of essential tremor.
In such case I would recommend starting low doses of propranolol if you don't have any peripheral arteriopathy.
Primidone would be another option of treatment.
Meanwhile, I would recommend taking trimetazidine or ranolazine for your microangiopathy.
Regarding fibromyalgia duloxetine or any other antidepressants would be helpful.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Feel free to ask any other questions whenever you need!
Greetings!
Dr. Iliri
I would recommend as follows :
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to have some more information on your tremor.
Is it a resting tremor or it is more prominent during intentional physical activity (holding the spoon, the cup of coffee, etc)?
Have you tried taking alcohol (a glass of wine, etc) does it relief your tremor?
Based on your DAT scan a parkinson disease can truly be excluded.
But some degenerative disorders affecting the small brain (cerebellum) can not be excluded.
A thyroid dysfunction could also mimic this clinical scenario.
I recommend performing thyroid hormone levels to rule in / out this possibility.
Have you tried any medications?
If alcohol relieves your tremor, this would be very indicative of essential tremor.
In such case I would recommend starting low doses of propranolol if you don't have any peripheral arteriopathy.
Primidone would be another option of treatment.
Meanwhile, I would recommend taking trimetazidine or ranolazine for your microangiopathy.
Regarding fibromyalgia duloxetine or any other antidepressants would be helpful.
You should discuss with your doctor on the above issues.
Hope to have been helpful!
Feel free to ask any other questions whenever you need!
Greetings!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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