I have had DBS surgery for essential tremor. I was doing well with the tremor but I spoke as I had suffered a stroke. In order to improve my speech my doctor lessened the power to the brain probes. My speech improved but my tremor came back, but not as severe as before DBS. Prior to the surgery I was on Primidone 50 mg (11 per day) with little relief. So I asked my doctor if I should resume Primidone. She said try 1/2 pill rwice daily. I did but it made me light headed. I am still trying to take the Primidone but now have developed a pain in my left temple which comes and goes. Could the Primidone cause this head pain? Do I have a cluster headache? Or could it be something more serious. I am a 74 year old male otherwise in good health but on blood pressure meds. My pressure has been well controlled.
Person's Gender: Male
Person's Age: 74
are you right handed?
waiting for you to come online
I needed to ask you about your stroke
because I have a good idea of why you might have left temporal head pain, but needed some information
well you are offline. so I will leave you an answer, please review it and get back to me.
so I am going to assume that you are right handed, and therefore, your speech cortex is in the left prefrontal cortex.
or the left side of your brain (that is the way it works in about 85 percent of us right handed people).
so I would like to ask you about your speech loss next, I assume again that you had Broca's aphasia
or an expressive aphasia. This is all part of the left prefrontal region, and you probably had right face and arm weakness
anyway. what happens in stroke, is that you take out a part of your brain from losing blood supply, but the part around that part is getting reduced blood supply. Over time, the blood vessels around that area, in the meninges or coverings of the brain, start to beef up or hypertrophy to supply additional blood flow to that circumfirential area. That we call collateralization of blood flow.
And that can cause headaches in the left temporal area.
the blood vessels on the outside of your skull also can get involved. they actually hypertrophy or enlarge and communicate with blood vessels inside your skull through tiny holes or foramina to increase blood flow to your brain.
All of this can cause head pain
So I would not say this is part of a side effect of Mysoline or primidone
because of the stroke, you cannot take nearly as much primidone as you used to.
primidone is a metabolite of phenobarbital, and it is a CNS depressant, it will effect your conciousness because of that stroke at higher doses.
So that is my answer, it isn't more serious, it is a result of the stroke.
the head pain
but I do not have any great ideas on controlling your tremor.
you could try some meds.
ask your neurologist about this
amantidine? maybe a starting dose like 50 mg twice a day?
amantadine is how it is spelled , hang on
here is a website on the medication. It is used to treat parkinson's but is also good for just tremor
I expect you have tried beta blockers like Inderal in your life, so I will skip that
get back to me to discuss further. If you are satisfied, please rate my service as that is how I am compensated for my work Dr Frank T.
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I don't think I had a stroke.
I'm right handed.
Hi. Sorry, my mistake. I misread your statement and thought you meant stroke, but you meant you lost your speech as if you had a stroke. So forget the whole thing about blood flow and ischemia and collateral flow. But I would guess there is still some type of connection as the stimulator cut your speech which is in the left prefrontal/temporal cortex, and that is the location of headpain. But why? I assume the electrodes are in your GP (globus pallidus, internal segment) to control your tremor. there is afferent neurons from there to the thalamus, and from the dorsal thalamus to the left speech area. (temporal lobe) Have you had a scan? I don't have an answer.
Lets change the approach. Lets say it is not related to the DBS. Could you have another problem like TMJ? (temporal mandibular joint pain syndrome?) I will attach a webpage on TMJ take a look at it and let me know. Have you had any tooth surgery? do you grind your teeth? Another possibility would be giant cell arteritis, this is a type of vasculitis, an inflammation of the blood vessels in your temple. There is a blood test called a sedimentation rate that you need. This disorder is associated with rheumatoid arthritis. Do you have that?
two webpages TMJ and temporal arteritis.
and the advice on the amantadine still applies.
get back to me if you have questions. if not good luck Dr Frank T
General Adult Neurologist. Board Certified. Experimental Neuroimaging and Neurodiagnostics
Thank you, Dr.
sorry I couldn't help more Dr Frank T.