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A tremor of a hand's thumb when holding an object
In August 2024, I began experiencing a tremor in the thumb of my left hand when holding an object. There was no tremor when the thumb was at rest.
The tremor occurred very sporadically in the following months.
However, towards the end of 2025, the tremor began to occur more frequently, to the point that in June 2026 I saw a neurologist for the first time.
I was initially diagnosed with Essential Tremor and prescribed PROPRANOLOL of 10mg.
I was asked to have an electromyography which did not show any nerve problems that could be the cause of the thumb tremor.
I took PROPRANOLOL for a month without any improvement in the tremor.
I was requested to have an MRI.
The report of the MRI indicated that basal ganglia spectroscopy showed changes suggestive of parkinsonism.
I was then prescribed PRAMIPEXOL 1 mg, one tablet in the morning and one at night.
I took the medication for a month without any improvement in the tremor.
I experienced however several side effects from PRAMIPEXOL.
I had episodes of daytime sleepiness, and dizziness together with muscle weakness when standing up after sitting or lying down.
The muscle weakness disappeared when I started moving, but the dizziness persisted throughout the day.
My neurologist reduced today the PRAMIPEXOL dose by half for 3 days and then asked me to stop taking it to assess whether the dizziness disappears.
What treatment change might the neurologist suggest?
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@mjch Like you, I have an essential tremor that is more pronounced when holding things - when I was unable to use propanolol, my neurologist tried primidone which worked for me. However, I do not like the side effect of feeling like I am fuzzy and walking through mud, so have weaned myself down to the smallest possible dose, and just tolerate the tremor.
Perhaps the doc will try a different medication. Have you been fully screened for Parkinsons?
@sueinmn Given the limited effect of Promipexol and the side effects it was causing, at the beginning of this week my neurologist prescribed Levodopa Carbidopa 25/250 mg. Half a tablet two hours after breakfast and lunch. Levodopa delivers dopamine directly to the brain, unlike the medications I had previously taken.
The tremor in my hand has lessened at times, but at other times there seems to be no improvement.
I continue to experience dizziness, especially in the mornings, although less intensely.
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1 ReactionMy Neurologist has been trying to find medication for the hand tremors. Topiramate 100mg am and pm worked wonderful (starts at 25mg and increase over time). But there were several drug interaction with my other medications.
Tried Propranolol - I passed out (I have low blood pressure and propranolol made it lower).
Tried Primidone - there were drug interaction with some of my other medications.
Neurologist recently prescribed Electroencephalogram (EEG) and I'm waiting on the results.
Levodopa Carbidopa - I checked the Mayo Clinic drugs supplements database and only found 2 minor
interactions. I'll ask the Neurologist what they think.
https://www.mayoclinic.org/drugs-supplements/carbidopa-and-levodopa-oral-route/description/drg-20095211
Best wishes,
🍀
@fourleaf The various medications prescribed for essential tremor seem to share a common side effect: a drop in blood pressure that causes dizziness. Since you have low blood pressure, your neurologist should be careful about what he/she prescribes you. Best wishes with your EEG results.