Q. I have tremors in left hand. Is it rubral syndrome or muscle weakness?

Answered by
Dr. J Mariano Anto Bruno Mascarenhas
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 24, 2016 and last reviewed on: Feb 10, 2020

Hi doctor,

I have tremors on my left hand. I am on Amantrel 100 mg tds, Frisium 30 mg and Propranolol 40 mg. I have been through two stents in my heart, but I have no myocardial infarction. I am on beta blockers Valent 40mg od and Retorlix 5 mg od. My neurologist says this as Rubral syndrome and my very senior physician said this is more likely to be muscle weakness because through a strict regime I have come down to 99 kg from 140 kg in the past 19 months. I would like to slowly discontinue Frisium because it makes me drowsy. My question is, should I taper one medicine after another just to see what works best? The physician told me to stop all medication completely which I do not think as a great idea. Can you please help?

Dr. J Mariano Anto Bruno Mascarenhas

Neuro Surgery Neurology Spine Health Spine Surgery


Welcome to icliniq.com.

I understand your concerns. Let me try to help you.

  • Muscle weakness will not cause unilateral tremors (involving one side). May be the tremors will start in one hand on first day, but within a week you will have tremors in both hands. So, this is not due to muscle weakness.
  • I would suggest that you stop Frisium (Clobazam) first to solve your drowsiness.

The Probable causes:

Rubral Tremors (Slow tremors at rest).

Differential diagnosis:

1. Parkinson's disease
2. Parkinson-plus disorders (group of neurodegenerative disorders)

Probable diagnosis:

Parkinson's disease.

Treatment plan:

Continue tablet Amantrel (Amantadine).

Preventive measures:

Do daily morning and evening 45 minutes of walk.

Regarding follow up:

Revert back after two weeks to a neurologist online.---> https://www.icliniq.com/ask-a-doctor-online/neurologist

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