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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5331
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I very started too expierience tremors in my arms and sometimes

Resolved Question:

I very started too expierience tremors in my arms and sometimes legs. I had a dac scan which said that part of my brain hadn't absorbed the radiation. Why would this be
Submitted: 3 years ago.
Category: Neurology
Expert:  Dr. Bob replied 3 years ago.

Dr. Bob :

Hello. How long have you had these tremors?

Customer: About 6/8 weeks
Dr. Bob :

Do these tremors occur at rest, or when you are doing things?

Dr. Bob :

Did you have a CT scan? Do you have the report?

Customer: I had a dac scan and they happen all the time. The result just said one piece of my brain wouldn't absorb the dye and they don't know why and will review mr
Dr. Bob :

The MRI is a much better study for looking at the brain.

Dr. Bob :

As for your tremors, there are many types. Most are benign, essential tremors.

Dr. Bob :

Tremors need to be evaluated by a neurologist to make an accurate diagnosis.

Dr. Bob :

Please let me know if you have more information or questions you would like to go over.

Dr. Bob :

The tremor of Parkinson's is typically a rest tremor, meaning it occurs when one is not doing anything, and are distracted. It usually fades with movement and activity.

Customer: It's worse when I stretch
Dr. Bob :

So you notice it primarily when you reach for something? This is an intention tremor or a postural tremor most likely.

Dr. Bob :

There are different categories, but most are benign in nature. Heightened emotion, stress, fever, physical exhaustion, or low blood sugar may trigger tremors and/or increase their severity. Onset is most common after age 40.

Dr. Bob :

See if you can get an appointment with a neurologist if you haven't seen one yet.

Dr. Bob :

He or she can pinpoint the type of tremor, rule out other possible causes, and suggest a treatment plan.

Dr. Bob :

Essential tremor may be treated with propranolol or other beta blockers (such as nadolol) and primidone, an anticonvulsant drug.

Dr. Bob :

Eliminating tremor “triggers” such as caffeine and other stimulants from the diet is often recommended.

Dr. Bob :

Physical therapy may be very helpful as well.

Dr. Bob :

Did you have any follow up questions about this?

Expert:  Dr. Bob replied 3 years ago.
Hi Helen. I did not hear back from you.

Did you have any further questions for me? If so, please let me know and I would be happy to assist you further.

Best wishes,
Doctor-Bob
Customer: replied 3 years ago.
Why would part of my brain not absorb the radiation
Expert:  Dr. Bob replied 3 years ago.
That implies that part of the brain is not as dense as it should be. This could be the result of a prior stroke, prior injury or prior infection. The important factors would be how large is the area and where is it located.
Customer: replied 3 years ago.
Would this be serious
Expert:  Dr. Bob replied 3 years ago.
This could be serious depending on how large the affected area is, and what part of the brain it is in. Do you have the MRI report?
Customer: replied 3 years ago.
No all I've had is what they called a dac scan and it showed up this problem. What could be worst case scenario?
Expert:  Dr. Bob replied 3 years ago.
Hi Helen. This is not a commonly utilized imaging modality. Where did you have this done and why? Have you also had an MRI?
Customer: replied 3 years ago.
I had it done t Leicester General and not had An mri I had this done cos doctor said it would show up better imaging
Expert:  Dr. Bob replied 3 years ago.
So no CAT scan (CT) and no MRI? And the tremor occurs only when you stretch your arms or legs? How's your gait (walking)? Is it normal?
Customer: replied 3 years ago.
I had a cat scan about 6 years ago as I was experiencing severe facial pain on the left hand side of my face accompanied with numbness. That showed a few whit blobs on the brain which they said was unusual too find in a person my age . I think I was about 42 . They said it was more common in the elderly. They tested me for ms and the lumber puncture came back negative. They said the pain was trigeminal neuralgia . Then this all happens a few years later. I occasionally over step myself or find myself tripping but have never fell over . I can also muffle my words. Please help as aim very worried.
Expert:  Dr. Bob replied 3 years ago.

I would suggest you get an MRI scan of the brain. This will provide lots of details. It should give more information about what those "blobs" may have been and whether there are any more of them now. This would be important in terms of ruling out central nervous system processes such as MS.

Customer: replied 3 years ago.
Even though the lumber puncture was clear could I still have ms?
Expert:  Dr. Bob replied 3 years ago.
Yes. An abnormal LP can support the diagnosis of MS, or show something else. But a normal LP does not rule out MS. It is mainly a clinical diagnosis (based on symptoms and history) as well as MRI findings.
Customer: replied 3 years ago.
So the tremors could possibly be ms
Expert:  Dr. Bob replied 3 years ago.
Yes, though this is usually not the first symptom we see. If combined with balance issues and/or speech issues, we would be more concerned with this possibility. Our next step would be to do a thorough neurological exam and probably order an MRI.
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