Print This Page     Close Window Consult Request Guidelines for Tremor     Tremor Suggested Pre-Referral Evaluation and Management Guidelines Assess for associated gait disorder, slowness of movement, ataxia, family history or alcohol abuse history. Assess for use of antipsychotics, antiemetics, amiodarone, valproic acid, Lithium, or asthma medications. Also assess for drug withdrawal and symptoms of thyrotoxicosis. Suggested Additional Test/Management Prior to Specialty Visit Thyroid function tests if indicated. If the patient is under the age of 50, or has any associated neurologic complaints, consider ordering a ceruloplasmin and 24 hour urine copper to exclude Wilson's. Consider trial of Inderal LA 60-80 mg/d OR primidone up to 100 mg qhs in mild familial case. Patient Education/Information (includes preps) 1) Education about medication side effects, withdrawal or familial tremor when appropriate 2) Parkinson's Disease Appointment Timeframe Patients with gait instability or associated neurologic illnesses should be seen within 1-2 months. Others can often wait up to 3 months, with trial of medications before visit. How to Get Results to Consultant UMHS Patients: See CareWeb External Patients: Hand carry non-UM records and MRI films to visit Clinic Contact Information Physicians: 800-962-3555 Patients: 734-764-6831 Clinic Location Sites East Ann Arbor Health and Geriatrics Center UM Consulting Physician Neurology - Movement Disorders Faculty Revised on: 10/01/2012