Are my tremors in left hand due to Rubral syndrome or muscle weakness?

Patient's Query

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?

Answered by Dr. J Mariano Anto Bruno Mascarenhas

Hi,

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

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