system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A 48-year-old woman presents to her family practitioner complaining of tremulousness of both hands for the past few years that have deteriorated over the past 7 months. She sometimes spills coffee while holding a full cup. She is a receptionist and her symptoms have led to difficulties with typing at work. She denies weight loss, diarrhea, fatigue, blurring of vision, walking difficulties, and heat intolerance. The past medical history is significant for well-controlled bronchial asthma. She does not smoke or use illicit drugs, but she drinks one cup of coffee daily. She drinks alcohol only socially and has noticed a decrease in her tremors afterward. She reports that her father had a head tremor, and her mother had hyperthyroidism. The patient is oriented to person, place, time and situation. On physical examination, the eye movements are normal and there is no nystagmus. She has a prominent rhythmic tremor of both hands that increase when hands are stretched with abducted fingers. The muscle strength, tone, and deep tendon reflexes are normal in all 4 limbs. The sensory examination and gait are normal. The laboratory test results are as follows:
Hemoglobin  14.8 g/dL
Leukocytes 5,500/mm3
Platelets 385,000/mm3
BUN  18 mg/dL
Creatinine 0.9 mg/dL
Na+ 143 mmol/L
K+ 4.2 mmol/L
Which of the following is the most appropriate management for this patient? 
assistant
Primidone