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What Causes Hand Tremors, Hypertension, Frequent Urge To Urinate And Somniloquy?
Question: Hello Doctors,
My dad is almost 70 years old. He was suffering from Trembling Hands & Hypertension for last 1 year. He is otherwise all active, does regular exercise, follows regular healthy home diet with no major medications or diseases. He used to be a regular smoker but has quit smoking completely for last 3 years. He does not have any other addictions and has always remained non-alcoholic. He frequently feels urge to pass urine but he gets time to find a place / bathroom and has never had wet pants (persistent for last 5 years). He speaks, shouts and sometimes throws fist / arms / legs during sleep (more than 5 years). However he has never done sleep walking.
We were worried about the Trembling Hands and when we consulted Neurologist, he suggested MRI. The MRI came with diagnosis of "Lacunar Pontine Infarct" and "Polyp in left maxillary sinus". I have attached all Reports including MRI, Echo Cardiogram and other Blood Test Reports.
I need your suggestion in understanding the risk of these diagnosis and what should be suggested medication or things to be done to avoid any future casualties. Are current medications correct or need any change?
Thanks in advance for your kind guidance.
Regards,
XXXX
My dad is almost 70 years old. He was suffering from Trembling Hands & Hypertension for last 1 year. He is otherwise all active, does regular exercise, follows regular healthy home diet with no major medications or diseases. He used to be a regular smoker but has quit smoking completely for last 3 years. He does not have any other addictions and has always remained non-alcoholic. He frequently feels urge to pass urine but he gets time to find a place / bathroom and has never had wet pants (persistent for last 5 years). He speaks, shouts and sometimes throws fist / arms / legs during sleep (more than 5 years). However he has never done sleep walking.
We were worried about the Trembling Hands and when we consulted Neurologist, he suggested MRI. The MRI came with diagnosis of "Lacunar Pontine Infarct" and "Polyp in left maxillary sinus". I have attached all Reports including MRI, Echo Cardiogram and other Blood Test Reports.
I need your suggestion in understanding the risk of these diagnosis and what should be suggested medication or things to be done to avoid any future casualties. Are current medications correct or need any change?
Thanks in advance for your kind guidance.
Regards,
XXXX
Brief Answer:
Get evaluated for diagnosis and continue medication
Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
Tremors in old age is commonly associated with essential tremor or parkinsonism.
Essential tremor person has family history of such tremors, bilateral without any slowness, stiffness or gait difficulty.
Parkinsons disease is associated with asymmetrical onset involving tremors in one hand,
stiffness, slowness, gait difficulty and may be fall.
The drugs are being given for Parkinson disease but you have not mentioned such specific findings.
Other medications for blood pressure and deranged lipid profile are OK and can be continued.
Mri brain may be required. This will be helpful in diagnosis of other degenerative disorders at this age.
You can also upload prescription of treating neurologist for documented clinical symptoms and signs.
Urinary complains may be a part of parkinsonism or age related benign prostate hyperplasia.
Get an ultrasound of abdomen and urodynamic study.
You can consult a neurology referral centre for complete work up and diagnosis if not satisfied with treating doctor.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Get evaluated for diagnosis and continue medication
Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
Tremors in old age is commonly associated with essential tremor or parkinsonism.
Essential tremor person has family history of such tremors, bilateral without any slowness, stiffness or gait difficulty.
Parkinsons disease is associated with asymmetrical onset involving tremors in one hand,
stiffness, slowness, gait difficulty and may be fall.
The drugs are being given for Parkinson disease but you have not mentioned such specific findings.
Other medications for blood pressure and deranged lipid profile are OK and can be continued.
Mri brain may be required. This will be helpful in diagnosis of other degenerative disorders at this age.
You can also upload prescription of treating neurologist for documented clinical symptoms and signs.
Urinary complains may be a part of parkinsonism or age related benign prostate hyperplasia.
Get an ultrasound of abdomen and urodynamic study.
You can consult a neurology referral centre for complete work up and diagnosis if not satisfied with treating doctor.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi Doctor,
I have attached MRI Report for Brain and doctor's clinical diagnosis. Plz review and suggest.
Thanks,
XXXX
I have attached MRI Report for Brain and doctor's clinical diagnosis. Plz review and suggest.
Thanks,
XXXX
Brief Answer:
Continue same medication, regular follow up
Detailed Answer:
Hello XXXX,
I have gone through your report and prescription.
The details mentioned in neurologist prescription reads right upper limb rest tremors which may be a starting stage of parkinsons disease. Though other detail findings are not available but if he is responsive to medication then continue and be in regular follow up. As this disease is progressive, not curable but controlled on medication.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Continue same medication, regular follow up
Detailed Answer:
Hello XXXX,
I have gone through your report and prescription.
The details mentioned in neurologist prescription reads right upper limb rest tremors which may be a starting stage of parkinsons disease. Though other detail findings are not available but if he is responsive to medication then continue and be in regular follow up. As this disease is progressive, not curable but controlled on medication.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Mri finding are being treated by drugs
Detailed Answer:
Hello dear,
Biggest risk for stroke is age.
Your father is also hypertensive which again is a stroke risk factor.
Your neurologist is already giving antiplatelet drugs.
Stroke can occur to any person.
Healthy life style, good food, fruits and regular exercise with timely medication are the key for stroke prevention.
God bless your father a healthy life ahead.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Mri finding are being treated by drugs
Detailed Answer:
Hello dear,
Biggest risk for stroke is age.
Your father is also hypertensive which again is a stroke risk factor.
Your neurologist is already giving antiplatelet drugs.
Stroke can occur to any person.
Healthy life style, good food, fruits and regular exercise with timely medication are the key for stroke prevention.
God bless your father a healthy life ahead.
Hope you found the answer helpful.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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