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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Epilepsy With Frequent Tremors

my brother is 25, a patient of epilepsy. first fit occured in 2005 and after that no fit occured for 3 years. then in 2008 fits started again with more frequency. then gradually tremors in his hands and legs increased in intensity and now its been 2 years that he has difficulty walking. he can take 2,3 steps only then another step may cause a fit as this further step increase the tremor to its most. he is on Epival since 2005 and for the last 2 years using Lerace as wel. his condition shows no improvement. Help me please and tell me what is the real disease of my brother and what wouldbe the treatment.

Tue, 1 Jul 2014
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Neurologist,  's  Response
Hi,

Thank you for posting your query.

I have noted your brother's symptoms.

He is suffering from epilepsy, and he is on good anti-epileptic medications, namely epival (sodium valproate) and levetiracetam.

Tremors are not related to epilepsy. So, we need to evaluate the cause of his tremors.

Tremors can occur as a side effect of sodium valproate. This can be controlled by using beta blockers such as propranolol.

In addition, tremors and difficulty in walking can also occur due to disease of cerebellum. This can be evaluated with MRI scan of brain.

I would request you to get back with MRI brain report.

Thyroid profile and vitamin B12 level should also be tested, as their deficiency can also cause tremors.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/
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Suggest Treatment For Epilepsy With Frequent Tremors

Hi, Thank you for posting your query. I have noted your brother s symptoms. He is suffering from epilepsy, and he is on good anti-epileptic medications, namely epival (sodium valproate) and levetiracetam. Tremors are not related to epilepsy. So, we need to evaluate the cause of his tremors. Tremors can occur as a side effect of sodium valproate. This can be controlled by using beta blockers such as propranolol. In addition, tremors and difficulty in walking can also occur due to disease of cerebellum. This can be evaluated with MRI scan of brain. I would request you to get back with MRI brain report. Thyroid profile and vitamin B12 level should also be tested, as their deficiency can also cause tremors. I hope my reply has helped you. I would be pleased to answer, if you have any follow up queries or if you require any further information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/