Brief Answer:
Familial Essential Tremor-- and you can take that to the BANK!

Detailed Answer:
Your description is classic for an entity referred to as FAMILIAL ESSENTIAL TREMOR and it is easily managed though never really CURED....the mechanism for why it happens is unclear but we believe the short circuit that begins the whole process is in the brain. The fact, that there is a 40% concordance rate in families suggests a genetic predisposition. It is mainly passed on among the men of a family but it can easily strike women as well. Therefore, your kids should be informed as to what Dad's got since they will want to know this information for future reference when asked by their doctors about their family medical history.

Also, the chances of the kids getting something similar are greatly increased if you have anything in your family of a similar nature since you may have gene mappings for this that you could've passed on to the kids which when combined with your husband's gene direction may make it more likely they can contract it or more severe, or earlier than what dad showed.

Your husband should be obviously seen by a neurologist to make sure that nothing else could possibly be to blame for this condition but if the examination is as you say and labs are normal then, I'm willing to put up next month's mortgage on this diagnosis. Of course, if you tell me that some doctor wants to try and convince you that he's got Parkinson's or something crazy like that then, the only way you get next month's mortgage is if you bring your husband to XXXXXXX and I get to examine him personally! LOL!

This is not Parkinson's, not seizures, not TIA's, and not from some accident he suffered in a drag race when he was 18 years old....this is FET....

The most common and benign drug to take that works like a charm in the majority of patients would be PROPRANOLOL......NOT metoprolol (written to be equivalent to propranolol---phooey on that thought!).....I have not found 1 single patient in over 25 years of practice who has responded to metoprolol equivalently as to propranolol when the diagnosis was FET....not one.....

There are other options if for some reason he can't tolerate that medication. Plus if he's never been on any medication and with his age being so young....I would start him out very slowly and at a very low dose then, slowly work my way up until we got the therapeutic effect. I would not start him off necessarily at recommended doses since he is virgin to this medication and you may overshoot him which actually makes things more difficult for him down the road when the tremor may become a bit refractory and you're going to either have to increase the dose or search for another med. So the idea is to find the absolute bare minimum he requires to treat the tremor adequately and no more.

I've even tried some patients on regimens of exercise therapy if they were willing to do intensive types of workouts and this has actually worked in lieu of using any medication.....but that's only for people who are highly motivated and likely to stay the course on a pretty tough workout routine designed to increased the neuromuscular junction density of connections in the UPPER EXTREMITIES and later the lower extremities. In those cases I send them to a local exercise therapist who will work with them on specific routines and within several weeks we are often seeing results which at least may reduce either the amount or the immediate need for medication.

I hope these answers address the question sufficiently and if so would appreciate your considering rating this interaction as a high star event with some brief written feedback. Also, in view of end of the month tallies and credits I'd very much appreciate if you'd CLOSE THE QUERY at this time (assuming I've provided with you enough information to get things well under way). We can always have more discussions under a separate thread at a later date if you so desire.

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