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Suggest Treatment For Hand Tremors

Posted on Mon, 27 Jun 2016

Question: i am facing the Shaking problem in my Palms Usually vibrate and Shake while Holding the its Still or Doing any Activity.Please Suggest.

Answered by Dr. Ajay Panwar (1 hour later)

Brief Answer:
Anxiety/Essential tremor/Drugs/Thyroid

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

If you would have presented to me as an outpatient with this complaint,I would have asked you the following details-
1)Do you remain frequently anxious?
2)Any history of Thyroid disorder?or any other disease history?
3)History of alcohol intake or other addictions?
4)Were you on any medicines prior to onset of these symptoms?

The above details are important to rule out the following common causes of postural tremors-
1)Anxiety/Stress
2)Alcohol or other addictions
3)Some medicines
4)Thyroid disorder

I shall be glad to have you in follow-up with details so as to answer this well further.

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

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

Follow up: Dr. Ajay Panwar (27 hours later)

Hi Sir

Thanks for your Response.
please find the Details below.

1:- I don't feel Very anxious often.
2:- No Thyroid disorder
3:- I take drink occasionally(once in a month or two) and i don't Smoke and no other addiction.
4:-I have taken Some Medication in Past Regarding this Problem.

and I have Attached MRI,CN Report,LFT Test and Doctor's Prescription.

Please suggest

Thanks & Regard's
XXXX XXXXXXX
+91-0000

Answered by Dr. Ajay Panwar (10 hours later)

Brief Answer:
Do you have any weakness or wasting?

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
I have gone through all your documents.

One of the prescriptions with Betacap-TR appears to be reasonable enough,considering your diagnosis as 'Essential tremor'.Did you show any improvement with this medicine?

However,I wonder that why you have been prescribed Riluzole.This drug is given in motor neuron disease.Although your EMG report says some large amplitude MUAPs,it does not mention of definite neurogenic pathology.These changes should not be there in absence of any weakness in extremities or thinning of extremities.
I suggest you to get a thorough neurological examination done by a neurologist in person to see for any definite abnormalities.

Hope that helps.If you have some further questions,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 (1 hour later)

Hi Sir

Thanks for Your Response

i am facing Weakness in my Hand.actually when i am Hold the High Wight in my hand So that My Left Side neck will be pain.

After taken all the Medicine no Improvement.
i am very unhappy for this Problem.
Sir Please Suggest in Brief manner How can i Solve this Problem. Please Suggest.
and if possible can you do the video chat with me related this issue.

BR//
XXXX XXXXXXX
+91-0000

Answered by Dr. Ajay Panwar (11 hours later)

Brief Answer:
Needs a neurological examination.

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

Sincerely speaking,you need to be seen by a neurologist in person and a through neurological physical examination to actually look for weakness and atrophy.Your electromyography does not go well with your clinical history.It needs to be determined whether you actually have anything close to neurogenic cause of weakness.Motor neuron disease,which might have been suspected,as appears from your prescription of Riluzole,should be ruled out.Physical examination is must for this.

Treatment depends on the diagnosis.

Hope that helps.If you have further questions,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 (8 minutes later)

Hi Sir,

Thanks for your Response

as per your Massage First thing is that i should need neurological Physical examination.

Sir can you suggest me one Doctor or Clinic for this Test in XXXXXXX location.

Answered by Dr. Ajay Panwar (9 hours later)

Brief Answer:
IPGMER

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

IPGMER/Institute of Neurosciences is a good facility with expert neurologists.Dr XXXXXXX XXXXXXX Dr.Goutam ganguly and Dr.Alak pandit are all fine.I think you should visit the place.In private,you can visit Dr XXXXXXX XXXXXXX Besides,I'm sure there must be other good neurologists as well in private.

Hope that I have answered your query.If you have some other questions,I shall be glad to have you in follow-up else please close the thread,rate it and write a review.

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

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