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CD-ROM Today 1996 January
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01892.txt
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1994-01-17
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$Unique_ID{BRK01892}
$Pretitle{}
$Title{Hand and Head Tremors}
$Subject{Hand hands Head tremor Tremors shake shakes shaking voice treat
treatment treatments medication medications drug drugs prescription
prescriptions diagnose diagnosis benign essential BET Parkinson reduce quaver
quavers Caffeine beta-blocker atenolol propanolol primidone clorazepate
antianxiety agent agents benign}
$Volume{}
$Log{}
Copyright (c) 1993 Tribune Media Services, Inc.
Hand and Head Tremors
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QUESTION: Over time, my husband has developed a shaking in his hands that
sometime even effects his head, lately his voice. Though he has visited his
previous physician on several occasions, he was told it was not serious and
that little could be done. Now a new doctor has taken the place of his
previous physician (who retired). Do you think there might be something new
to help that this young doctor might know of? Money is too tight for another
visit that provides no relief. Please try to help us.
------------------------------------------------------------------------------
ANSWER: There are a number of medical treatments that offer hope to those who
develop problems with hands and head that shake. However, since there are
several conditions that can cause tremors, it is important to determine the
exact diagnosis, and then the appropriate medication. I can't do that for
you, but this new "young" doctor should be able distinguish between the
clinical causes of tremor.
Just going on the information in your letter, I might suspect that your
husband has benign essential tremor (BET), rather than Parkinson's or some
other condition associated with hands that shake. I believe that is why your
previous doctor told you not to worry and did not offer a medicine to try to
reduce the tremor. BET is a fine to coarse tremor that can effect hands most
frequently, may also cause the head to shake and the voice to quaver. It may
only affect one side, can disappear when the hand is resting, but intensifies
when trying to perform intricate movements. Caffeine and some medications
may also aggravate the tremor.
The first choice in medications is a beta-blocker, atenolol or
propanolol. The medicine is given in gradually increasing doses until the
desired result is obtained or side effects occur. Another medication,
primidone, in 100 mg dose at bedtime can often work if the patient has no
problems with the medication. Other medicines listed as effective for this
type of tremor are clorazepate and antianxiety agents. They all work better
on the tremor of the hands than on the head or voice. Whichever medication
your new doctor decides on, he will start with a low dose and keep adjusting
the dose until the tremor is reduced or side effects prevent him from adding
any more medication. Patience is a must, but good results are possible, if
you stick it out.
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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician. Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.