Fwd: tremor

[Guest guest]

I was sure I had pased this on but haven't seen it on Care.

It was posted on PIEN and I thought it interesting:

>, , , and others:

>

>This posting is intended to clarfy some of the questions you all voiced

>about tremor and PD. Since there was some confusion about the thread, I

>started a new thread which could easily be identified.

>

>PD is usually accompanied by tremor - the so-called resting tremor. This

>tremor usually (but not invariably) decreases in intensity when you do

>something voluntarily. Some patients with PD may also have essential or

>action tremor - which does not decrease when you do something voluntarily.

>

>Both types of tremor may need separate treatment. The resting tremor or PD

>tremor is treated with the usual drugs for PD - levodopa (Sinemet or

>Madopar), pergolide (Permax), pramipexole (Mirapex), or ropinorole

>(Requip) - as well as trihexyphenidyl (Artane) or benztropine (Cogentin).

>There are other drugs sometimes used less frequently.

>

>The action tremor is treated with propranolol (Inderal, a beta blocker) or

>with primidone (Mysoline) most often.

>The FDA has not approved the use of

>primidone specifically for tremor. Neurologists use it widely and often for

>essential tremor, a so-called " off-label " use for a drug. This is common

>practice and perfectly legal, in which drugs marketed for one purpose find

>utility for other purposes.

>

>The absence of tremor in a Parkinsonism does not automatically mean that the

>long term outlook is worse, but it should alert the Neurologist to the

>POSSIBILITY that the person is afflicted with one of the more unusual forms

>of Parkinsonism.

>

>Signs and symptoms of Parkinsonism are most often due to Parkinson's

>Disease, from which the word Parkinsonsim is derived. However, there are

>other diseases that resemble Parkinson's Disease that also cause many of the

>signs and symptoms of Parkinson's Disease such as rigidity, slowness, poor

>balance, gait problems.

>

>Some Neurologists refer to these as the " Parkinson-plus " syndromes, or the

> " Parkinson-look-alikes. " A few of these have been mentioned i

>n this list

>every so often: Progressive Supranuclear Plasy (PSP), Shy Drager Syndrome,

>Multiple System Atrophy, Diffuse Lewy Body Disease,

>Cortical-Basal-Ganglionic Degeneration (CBGD), to name a few. These are

>rare diseases in comparison to Parkinson's Disease. They tend to produce

>tremor LESS often, but produce MORE rigidity and slowness and gait problems.

>These diseases TEND to progress faster and are more disabling than PD, and

>respond less well to the medications used.

>

>That is the basis for someone stating that the absence of tremor may be a

>poor sign - the possibility that the afflicted person may have one of these

>more aggressive disorders. The diagnosis most often is made by observation

>and time. Most of these diseases, as they advance, develop special signs

>that help classify them more accurately. In practice, the treatment is the

>same, for the most part.

>

>I hope that clarifies most of the questions regarding tremor types and

>prognosis is PD.

>

> Romero, M

>D

>3600 Gaston Avenue

>Dallas, Texas 75231

>

>