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Dr. Frank, Board Certified Physician
Category: Neurology
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Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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This must be answered by a neurologist. Over the past five

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This must be answered by a neurologist. Over the past five years I've been having episodes of tremors that have lasted weeks at a time, and have been misdiagnosed as panic attacks. I probably had a panic attack during the episode because I didn't know what was going on, but panic attacks don't last for weeks.
I had a severe episode of tremors from Dec. 2012-Feb.2013. I saw a neurologist without a subspecialty and all she wanted to prescribe me was Trazadone, which I had already taken a long time for insomnia. I got lucky with my second HMO neurologist referral, and he was a movement disorder specialist that correctly diagnosed me with severe Essential Tremors, now considered a separate disease by the AMA, code 333.1 and also labeled as being disabled. His contract was cancelled by my HMO as of July 31, 2013.
My HMO is only referring me again to neurologists that are not movement disorder specialists. When I call their offices, they specialize in other disorders like MS or pediatric neurology.
How important is it for me to see a movement disorder neurologist since I want to be prescribed the right medications,the correct dosages, and be cared for properly?
Thank you!
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

neuromd2012 :

Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.

neuromd2012 :

I would say that any general neurologist should be able to treat you for essential tremor, that you do not need a neurologist for an initial evaluation and management. Once quality of life issues put you in the moderate to severe group, then you might see a movement disorder specialist at a more tertiary care center to discuss DBS (deep brain stimulation), or DAT Scan imaging for diagnosis, or to discuss a newer treatment on the horizon, high frequency MRI guided ultrasound therapy.

neuromd2012 :

I am here to discuss you case when you come back online, please ask questions that I can answer. Dr Frank t

Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7202
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you
Customer: replied 1 year ago.


Hi, (for a Neurologist)


 


I still don't feel that comfortable though with a regular neurologist for the Essential Tremors. The episode started basically in November and gradually increased to these terrible tremors alternating through my arms, legs, head, and tongue, and the first neurologist I saw in January only thought clonazepam (I was panicking by then!) was the short-term solution for two weeks, and that Trazadone was my long-term solution? She didn't even consider Essential Tremors even though I had been asking her about shaking hands and yearly tremor episodes for about five years (the episodes weren't as bad as the one in 2013).


So because this is my brain we're talking about and not my toe nail fungus, how am I supposed to trust another neurologist that doesn't specialize in movement disorders to prescribe me the right medications and dosages with Inderal, Remeron, and Primidone or whatever else medication? Do you see why I'm doubting the HMO referrals?


Since Essential Tremors is now considered its own separate disease and code since December 2012, shouldn't I be seeing a specialist?


Most doctors still think of it as benign tremors that older people get, and don't take it too seriously when I bring it up....

Expert:  Dr. Frank replied 1 year ago.
The botXXXXX XXXXXne is that you have to see a Physician with whom you are comfortable. As a general Neurologist, I see patients with ET all the time. The word "benign" has been dropped from the name. For most patients with ET, the concern has been that this is Parkinson's and the DatScan is one method to differentiate between these two entities. Psychogenic tremor, or tremor which comes on from stress/anxiety conditions is part of this differential, if you doctor feels this is psychogenic, he may not be willing to send you to a movement specialist (you should ask). ET is without question in the category of a movement disorder, and treatments are evolving, and you need the correct diagnosis.
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 7202
Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
Dr. Frank and other Neurology Specialists are ready to help you

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