#68 Tremors: One degree of Kevin Bacon?

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 20 November 2017

⏱️ 64 minutes

🔗️ Recording | iTunes | RSS

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Summary

Steady your hand and annihilate tremor with tips from Neurologist, and Movement Disorder specialist, Andres Deik, MD, Assistant Professor of Clinical Neurology at Kashlak Memorial Hospital (we can’t tell you where he really works: ) We teach you to differentiate benign causes of tremor from Parkinson’s disease with simple history and physical exam skills, plus nonpharmacologic and pharmacologic therapies for tremor. Special thanks to Beth Garbitelli and Chris Thrash who wrote and produced this episode and the show notes!

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

00:00 Intro and disclaimer
01:08 Listener feedback - Paul is not fired.
02:09 Picks of the week.
05:35 Dr. Deik intro
07:19 Icebreaker questions
12:20 Wikipedia definition
13:02 Classifying tremor
14:33 Postural tremor vs. reemerging rest tremor
15:48 Important history questions
17:58 Medications that can induce tremor
21:39 Physical exam techniques
27:30 Exam characteristics between typical PD tremor and ET
28:36 History components to distinguish between PD and ET
34:10 Misdiagnosis of Parkinson’s
36:54 Imaging workup
39:03 Case from Dr Deik
41:33 Nonpharmacologic management
44:18 Pharmacologic management
49:06 Dosing propranolol
51:07 Distinguishing between physiologic tremor and pathologic tremor’
54:06 Website recommendations
55:50 Handwriting
59:14 Take home points
61:34 Outro

Tags: tremor, essential, postural, neurology, Parkinsons, disease, beta, blockers, primidone, movement, disorders, antidepressants, occupational, therapy, rest, intention

Transcript

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0:41.4	Hello.
0:42.4	The Internal Medicine podcast that uses expert interviews to bring you clinical pearls
0:46.9	and practice changing knowledge.
0:48.9	I'm Dr. Matthew Wato here with my two co-hosts Dr. Stuart Brigham.
0:54.2	That's me still.
0:55.2	Dr. Paul Williams.
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0:59.0	I'm Dr. Paul.
1:00.0	Paul always sounds like he's here reluctantly.
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1:04.0	He feels a little bit like a hostage situation.
1:07.6	He didn't show up like a minute before we started recording.
	...

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