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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have minor blood pressure. What is the cause of head nodding?

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Dr. Ganesh Sanap

Radiologist

Practicing since :2007

Answered : 561 Questions

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Posted on Thu, 7 Feb 2013 in Brain and Spine
Question: My husband, age 69, has had minor head bobbing. That's the best way I can describe it. It looks like he is saying yes. It's not constant and it's not severe, it seems to happen only when he is relaxed, like when he's reading his computer or such. He is very healthy and fit. We have been vegetarians for over 20 years and his only issue is a minor blood pressure problem. He is very high strung and hyper. We have our own business which can be stressful and he has been using acupuncture to help calm him down-not sure if it is working. He is unaware of doing it, even if I mention it to him. This is not a concern now but my fear is it might progress. Can you shed some light on this? Thank you in advance -XXXXXXX
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Answered by Dr. Ganesh Sanap 1 hour later
Hi,
Thanks for writing in.

There are two causes of head nodding, Essential tremor and parkinsons disease.

Essential tremor is a neurological disorder which causes involuntary shaking or trembling of particular parts of the body, usually the head and hands. For some people, the condition worsens if they hold their bodies in certain positions (postural tremor). Other people may experience in motion of head (kinetic tremor). Generally, essential tremor gradually gets worse with advancing age.
In parkinsons disease, head nodding is associated with bradykinesia ( a characteristic slowness of movement), rigidity (difficulty moving) and tremors.

From your history it looks like your husband has essential tremors. It will be very useful if you consult your physician and get him evaluated to rule out parkinsonism. Depending on the exam findings, we may need to start him on medications.
Hope that helps. Let me know if you have any more questions.
Regards.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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PROTOCOL:

-     SE T1W & TSE T2W SEQUENCES IN SAGITTAL PLANE.
-     TSE T2 W SEQUENCE IN AXIAL PLANE.
-     STIR SEQUENCE IN CORONAL PLANE.
-     MR MYELOGRAPHY USING HEAVILY T2W SEQUENCE IN SAGITTAL AND CORONAL PLANES ON A 1.5 TESLA SCANNER.

There is some degree of straightening of lumbar lordotic curvature. Vertebrae are normal in height, alignment and marrow signal intensity.
Dessicative disc changes and anterior osteophytes are noted at multiple levels. Disc height is reduced at L4-5 with degenerative endplate changes at this level.

There is diffuse disc bulge, thickened ligamentum flavum & facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R). The mid sagittal diameter and area of spinal canal are 0.8cm and 0.75cm² (lower normal limits are 1.0cm and 1.5cm² respectively. Effusion is detected in the facet joints.
Annular tear, diffuse disc bulge and facet joint arthropathy are visualized at L3-4 indenting the thecal sac.
Diffuse disc bulge is observed at L5-S1 mildly compromising the neural canals bilaterally.

Cord ends at L1 vertebral level and shows normal signal intensity. No abnormal pre or paraspinal soft tissue mass is seen. MR myelography confirms the above findings.

Impression      :     MR findings reveal lumbar spondylotic changes with
     -     Diffuse disc bulge, thickened ligamentum flavum and facet joint arthropathy at L4-5 compressing the thecal sac and causing spinal canal stenosis with bilateral neural canal compromise (L>R).
     -     Annular tear, diffuse disc bulge and facet joint arthropathy at L3-4 indenting the thecal sac.
     -     Diffuse disc bulge at L5-S1 mildly compromising the neural canals bilaterally.

-     To be correlated clinically.

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