Father, son affected by same tremors

DEAR DR. GOTT: My 49-year-old ex-husband has recently been diagnosed with Parkinson’s disease. We divorced because he drank a lot of alcohol to relieve some of the tremors. He was a truck driver but lost his job because he could not hold on to the steering wheel and was taken off the job by ambulance. I recently took him to detox.

His tremors started around age 8, but the symptoms have become more severe. His primary-care physician diagnosed him with the Parkinson’s. He doesn’t want to see a neurologist because of the expense, especially now that he no longer has an income. The neurologist wants $350 just to walk in the office. I am trying to help him get state help and Medicaid.

Should he stay with his primary-care physician? Or should he “bite the bullet” and see the specialist?

Also, I just found out that his son from another marriage started having tremors at the age of 6. He is now 8. Should he be concerned? Should I tell the boy’s mother to take the child to a neurologist?

I know that my ex and I are no longer married, but he has no one around, and I just can’t let him “hang out to dry,” so I appreciate any help you can give us.

DEAR READER: Based on your letter, I believe your ex-husband needs to be seen by a neurologist.

There are several causes for tremors but very few that begin at such a young age. Also, given your husband’s use of alcohol to reduce the tremors, I believe that the diagnosis of Parkinson’s disease is premature, if not inappropriate.

A common condition known as benign essential tremor (BET) is more fitting of your husband’s symptoms. While rare, it can start in early childhood. This leads me to believe it is the type of essential tremor known as familial, meaning it is inherited. Familial tremors commonly respond favorably to alcohol intake but may worsen if too much alcohol is consumed; therefore, it is an inappropriate therapy option. The tremor may also worsen or begin to affect other areas of the body over time, such as the arms and/or head.

I urge your husband to be examined by a neurologist and his son by a pediatric neurologist. It may even be beneficial for them to be seen at the same time to determine whether their symptoms have a common, familial cause.

This is one situation where I don’t believe a general practitioner is best suited to make the diagnosis. I recommend you call a local neurologist and ask whether there is any way to set up a payment plan or to reduce fees because of your ex’s current situation. It would be far better to pay the price to confirm or deny the diagnosis of Parkinson’s disease than to begin expensive treatment for a condition he may not have.

If your ex-husband consents, it may be helpful to accompany him to the appointment to ensure that the physician is aware of all the symptoms, when they began and his choice of alcohol to reduce the tremors.

To provide related information, I am sending you a copy of my Health Report “Parkinson’s Disease.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a check or money order for $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.