Suggest treatment for leg tremors

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Posted on Fri, 8 Jul 2016 in Headache and Migraines
Question: Dear Dr.,
I'm suffering from a combination of essential, orthostatic and resting tremor which really got worse during the last year. Especially my legs when seated. last few weeks I feel i have a tremor in upper body when I awake and I suffer from strange kind of feeling in upper legs and upper arms they feel like sleeping. Tandem gait test is positive, I have hyperreflexes (knees arms) and hoffmann is positive.
Last month I got hospitalized at Stroke unit because I had this weird sensation in my head I felt like being awefully drunk and I couldn't walk straight anymore. In the morning of that same day I had a terrible pain in my right eye and was photophobic on that side. I had to wear my sunglasses. By noon time this disappeared and eye was normal again, just one hour later I started to have this strange sensation in my head like I just wrote. I went to see my family doctor and he send me to the ER of the universitary hospital. I'm having also Factor V Leiden (heterozygote) and she didn't want to take any risk concerning a stroke. The neurologist came to see me at ER and she said I was having signs of TIA.
I had CT-scan, MRI of head and last week aswell MRI of spinal cord. Everything was ok. I still need to have EMG for my tremor and in August I can go and see the neurologist again.
I feel that my power in my upper legs and upper arms are sometimes going. It's a real strange sensation. Walking down from stairs is also not easy I always have to hold myself and look were my feet are going. Sometimes my knees are really shaky doing this.
The neurologist put me on Rivotril (Clonazepam) 0.5mg a day. I feel that my tremor in my hands is a bit better but my legs is still as bad as before.
I am an audiologist so working with my hands (fine motor skills) are very important.
Could you please advice me what I should do, and what you think might be causing me these problems. I didn't get any answer so far and my next appointment is in august.
Thank you for your feedback,
With kind regards,
XXXX
doctor
Answered by Dr. Neeraj Kumar 58 minutes later
Brief Answer:
Get back with reports and details

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Tremors in resting and action involving all limbs with normal MRI at this age can be essential tremors, stress related or some secondary cause like hyperthyroidism.
Is there any similar complains in family members?
Another possibility may be spino-cerebellar ataxia which requires detailed examination and evaluation.
You can upload prescription of Neurologist mentioning clinical findings.
You can also upload blood reports.
For treatment clonazepam can be increased along with addition of propranolol or primidone as needed.
Do get back to me with reports.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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