Kelly L Sullivan1, Robert A Hauser, Theresa A Zesiewicz. 1. Department of Neurology, Parkinson's Disease and Movement Disorders Center, Tampa General Hospital Healthcare, University of South Florida, Tampa, Florida 33612, USA.
Abstract
BACKGROUND: Essential tremor (ET) is the most common adult tremor disorder and is characterized by postural and kinetic tremor. Symptoms are typically progressive and potentially disabling, often forcing patients to change jobs or seek early retirement. Proper treatment is contingent on a correct diagnosis, and other possible causes of tremor must be excluded. REVIEW SUMMARY: Although primidone and propranolol have been regarded as the mainstays of pharmacologic therapy for ET, additional agents may be useful in reducing tremor. Surgical procedures are available that effectively ameliorate tremor that is refractory to medical management. This article reviews the epidemiology, pathophysiology, and treatment options for ET. CONCLUSIONS: Despite a range of treatment options currently available, further research is necessary to manage this syndrome most effectively. Double-blind, controlled trials are needed to determine whether primidone, propranolol, or a combination of these medications is superior in the initial management of ET. Other pharmacologic agents have shown potential to reduce tremor and should be investigated further. Additional studies are also needed to determine the best treatment of head and voice tremor with pharmacologic and surgical interventions. With proper treatment, tremor is sufficiently reduced in the majority of patients.
BACKGROUND: Essential tremor (ET) is the most common adult tremor disorder and is characterized by postural and kinetic tremor. Symptoms are typically progressive and potentially disabling, often forcing patients to change jobs or seek early retirement. Proper treatment is contingent on a correct diagnosis, and other possible causes of tremor must be excluded. REVIEW SUMMARY: Although primidone and propranolol have been regarded as the mainstays of pharmacologic therapy for ET, additional agents may be useful in reducing tremor. Surgical procedures are available that effectively ameliorate tremor that is refractory to medical management. This article reviews the epidemiology, pathophysiology, and treatment options for ET. CONCLUSIONS: Despite a range of treatment options currently available, further research is necessary to manage this syndrome most effectively. Double-blind, controlled trials are needed to determine whether primidone, propranolol, or a combination of these medications is superior in the initial management of ET. Other pharmacologic agents have shown potential to reduce tremor and should be investigated further. Additional studies are also needed to determine the best treatment of head and voice tremor with pharmacologic and surgical interventions. With proper treatment, tremor is sufficiently reduced in the majority of patients.
Authors: Sheng-Han Kuo; Guomei Tang; Elan D Louis; Karen Ma; Rachel Babji; Matthew Balatbat; Etty Cortes; Jean-Paul G Vonsattel; Ai Yamamoto; David Sulzer; Phyllis L Faust Journal: Acta Neuropathol Date: 2013-03-31 Impact factor: 17.088
Authors: Petra Schwingenschuh; Diane Ruge; Mark J Edwards; Carmen Terranova; Petra Katschnig; Fatima Carrillo; Laura Silveira-Moriyama; Susanne A Schneider; Georg Kägi; Francisco J Palomar; Penelope Talelli; John Dickson; Andrew J Lees; Niall Quinn; Pablo Mir; John C Rothwell; Kailash P Bhatia Journal: Mov Disord Date: 2010-04-15 Impact factor: 10.338