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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I'm 67 years old and I started having a tremor in my lips

Customer Question

I'm 67 years old and I started having a tremor in my lips just before an ear surgey.
It has been there for 3 months.
It stops at night.I'm taking Inderal,but it is not working that much.
My tests are normal,and I had a brain MRI.
What could be
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello Welcome to JA. I will review your statement and reply shortly. Please read this preliminary answer and respond. Dr Frank

Expert:  Dr. Frank replied 1 year ago.

I would expect from here that your diagnosis is ET, essential tremor, but that you haven't responded as you had hoped to a beta blocker, Inderal or propranolol, and to Clonazepam a benzodiazepine. That does not mean you don't have ET, just that you are refractory. There are some newer treatments and testing modalities out there to prove you have ET, so that would be my suggestion. The first is a scan called DATscan, that measures the dopamine transporter occupancy in your brain, it tells you how much dopamine you have in selected areas of the thalamus and brain stem nuclei that are commonly effected in ET, so it will tell you if you have ET, or Parkinson's or some other condition. You need to discuss this scan with a neurologist who can arrange it for you. The tracer is manufactured by GE, so if you would like information, I can send it to you. The next idea is a new treatment that is awaiting FDA approval. The clinical trials were done at the Univ. of Virginia, and it is in use around the world with good results, yet the FDA has delayed its use here. It is called MRI guided high frequency ultrasound. I will get some information on it and send it to you. Please review this information and reply if you have questions. Or, if satisfied, please remember to rate this service by clicking on the rating stars, as that is how I am compensated for this work. thanks Dr frank