(1 Oct 97) New Kaiser Neuro
Yesterday, following retirement of my neurologist for the past 3
years, I had the first visit with the one newly assigned to me.
Dr. Lorie Purino is one of 3 neuros on the staff at Kaiser Woodland
Hills, and while not a movement disorders or PD specialist appeared
young, smart, and extremely competent. After an impressively smooth
and professional neurologic exam, she concluded that I have PD all
right, and was a bit concerned that for the past 3 years I've been
taking 150 mg/day (50 at 6AM, Noon, and 6PM) of Mysoline (primidone)
for tremor. She warned me to taper off gradually, otherwise I might
have a "siezure".
Alcohol, Mysoline (primidone), and Inderal (propranolol) are the 3
best known remedies for essential tremor, and of somewhat disputed
value against tremor of PD. Alcohol is very effective for me; one
glass of beer or wine will eliminate all tremor, but only for an
hour or two. Inderal is mentioned in the ('95) PDR as useful against
essential tremor only, but primarily intended for use against high
blood pressure or excessive pulse rate. I have neither of the latter
conditions, and although Inderal was effective against the tremor,
I quit after a day or so when my resting pulse dropped from a normal
55/min to an alarming 42/min. This left the third choice, Mysoline,
which is described and advised as an anticonvulsant for persons with
epilepsy. The recommended dosage, for patients 8 years or older, is
100 mg/day to start, increasing over 10 days to 750 mg/day or
maintenance need, but not over 2000 mg/day (recall, my own dosage is
only 150 mg/day).
Perhaps Dr. Purino thinks I have or might have epilepsy, even tho
neither I nor any of my family have ever had a siezure or any other
sign of that disorder. Taking her advice at face value and on faith,
I skipped the usual noontime dose of 50 mg and, after an admittedly
strenuous 230 miles of stop-and-crawl freeway driving, by 6PM my
right arm tremor was so pronounced I could barely write these notes
in longhand. I took my usual dose of 50 mg at 6 PM and now (8:30 PM)
the tremor, as usual, is practically absent. I don't quite see why
NOT taking a drug for a disease I DON'T have would cause symptoms
of that disease. And the Mysoline positively helps the tremor,
wherever it comes from. Maybe I should ignore the neuro's advice
and keep on with the former Mysoline dosage of 150 mg/day, and
perhaps even raise it gradually as the need grows with age.
Comment, anyone?
Joe
J. R. Bruman (818) 789-3694
3527 Cody Road
Sherman Oaks, CA 91403-5013
