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- Title
Treatment of essential tremor: current status.
- Authors
Sharma, Soumya; Pandey, Sanjay
- Abstract
Essential tremor is the most common cause of tremor involving upper limbs, head and voice. The first line of treatment for limb tremor is pharmacotherapy with propranolol or primidone. However, these two drugs reduce the tremor severity by only half. In medication refractory and functionally disabling tremor, alternative forms of therapy need to be considered. Botulinum toxin injections are likely efficacious for limb, voice and head tremor but are associated with side effects. Surgical interventions include deep brain stimulation; magnetic resonance-guided focused ultrasound and thalamotomy for unilateral and deep brain stimulation for bilateral procedures. Recent consensus classification for essential tremor has included a new subgroup, 'Essential tremor plus', who have associated subtle neurological 'soft signs', such as dystonic posturing of limbs and may require a different treatment approach. In this review, we have addressed the current management of essential tremor with regard to different anatomical locations of tremor as well as different modalities of treatment.
- Subjects
THALAMUS surgery; ADRENERGIC beta blockers; BOTULINUM toxin; MAGNETIC resonance imaging; PARASYMPATHOMIMETIC agents; TRANSCRANIAL magnetic stimulation; PROPRANOLOL; PRIMIDONE (Drug); ABLATION techniques; COMPUTER-assisted surgery; GABA modulators; DEEP brain stimulation; ESSENTIAL tremor
- Publication
Postgraduate Medical Journal, 2019, Vol 95, Issue 1128, pN.PAG
- ISSN
0032-5473
- Publication type
journal article
- DOI
10.1136/postgradmedj-2019-136647