What will be diagnosis Why PPI stops internal shaking Any suggestions

60/F no co-morbidities in past ,Wt 48kg (2 kg loss in 2 months), Chief Complaints Palpitation,Epigastric burning, internal shaking sudden onset early morng No vomiting/fever/dysnoea/fainting Vitals HR 80 BP 110/80 spo2 99 Rs clear CNS GCS 15/15 P/a soft CVS norml s1s2 no lymphadenopathy pallor icterus rash lump Physical Examination No H/O covid19 Investigations Hgm 12/7000/2.20, RFT LFT normal, Ca, Mg& ultra TSH Normal , B12 vit D3 normal , lipid normal urine N BsL R 98 CRP ESR within range ECG NSR 2decho N ,Holter N ,TMT N HRCT N USGa+p N ,Ca 125 CA 19.9 Both N Uppar GI scopy- La-A esophagitis,lax GE junction, Antral gastritis. HPEno Malignancies NO Hpylori Diagnosis Considering GERD with associated int shaking Management T pan 40 bd then od then 20od T ciplar 10bd T oleanz 2.5 hs First 2month no relief at all In the 3rd month all symptoms has disappear d But since last 2week she starts palpitation intermitantly int shaking 3/4times per day After tapering of PPI &ciplar


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