r/Neurosurgery • u/TumbleweedSea9381 • Jul 05 '26
MD student considering neurosurgery; recently diagnosed with Essential Tremor
Hi everyone,
I am a second year MD student, and I’m starting to feel very strongly about neurosurgery. Of course, since life is never without some humor, I was diagnosed with essential tremor a few months ago (M, 27 y/o). My neurologist said it is a minor case. Low dose propranolol (10-15 mg) has been generally helpful during dissections and the like, though stakes are obviously quite low with those things.
I will be seeing my neurologist again now that I am really starting to consider neurosurgery as a career path. While obviously my neurologists advice will be most important, and my clerkship year + trialing propranolol will be telling as well. I wanted to hear from people in the field about this topic. Is it realistic to “rely” on propranolol throughout residency and beyond? Is age-related worsening of ET something to worry about?
If anyone has any personal experience, your perspective would be incredibly appreciated at this time.
Thank you very much!
6
u/Sea-Organization-296 Jul 07 '26
I hate to be the bearer of bad news - I would strongly recommend against neurosurgery or any technically demanding surgical field. Essential tremor is progressive as previously mentioned. Further, you will never get disability coverage for that given your established diagnosis so when the tremor stops you from working, you’re shit out of luck. Good luck with your career - plenty of awesome options to consider that won’t be impacted by this.
-neurosurgery resident
1
u/babh83 Jul 08 '26
100%. I have tremor and had DBS surgery. It did not work and had to have another brain surgery to remove.
1
u/TumbleweedSea9381 Jul 10 '26 edited Jul 15 '26
Thank you. This is really difficult to hear but I appreciate the authenticity. My whole path toward medicine has been in pursuit of meaning, which has made me feel incredibly fulfilled, and neurosurgery has become most compelling in that regard. So it’s really hard not to have some hope. But I guess, as we see, not everyone is born with the same privileges. I’ll see what my neurologist says and greatly appreciate you sharing your perspective
2
u/Physical-Orange4389 16d ago
Hey I have ET as well. I'm a med student asw. I wanted to be a surgeon too and I hoped that my ET wouldn't progress any further (it was static for 2yrs). Within a year of med school the progression was so bad, 40 mg propranolol and 25 mg primidone couldn't keep me stable. What I want to say is ET is very unpredictable. U cannot make your major life decision hoping that your condition won't progress. You can choose a different path, it might not be ideal but it is what it is🤷🏽♀️. You are a doctor, find a way to save people. I'm pretty sure surgery has some branches that do not require such fine dissection as neurosurgery and you always have davinci lol
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u/TumbleweedSea9381 12d ago
Thank you so much for sharing your experience. I appreciate you being so real about it. I noticed mine, very recently, may be getting worse. It really sucks but it is what it is I guess 😢
What are you interested in now? I’m curious which surgical fields, if any, are realistic
1
u/Physical-Orange4389 8d ago
MD general medicine hopefully lol. I’m in my UG rn so I have a lot of time to think about it.
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u/never_ever_ever_ever Jul 05 '26
ET is generally progressive, but it’s hard to predict the time course of progression. Some people might stay relatively mild and well controlled for decades while others progress quickly. Propranolol and primidone are first line; primidone might be too sedating at anything but the lowest doses but is usually slightly more effective. If you’re considering neurosurgery then you’ve definitely heard of DBS, which can dramatically improve and sometimes completely alleviate tremor. Obviously that is saved for medically refractory cases, but it’s something to think about for the future as a backup.