Essential tremor. Epidemiology, diagnosis, and treatment.
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.


RESULTS
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.
Sullivan
Kelly L
KL
Department of Neurology, Parkinson's Disease and Movement Disorders Center, Tampa General Hospital Healthcare, University of South Florida, Tampa, Florida 33612, USA.
Hauser
Robert A
RA
Zesiewicz
Theresa A
TA
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D020329:Essential Tremor / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D013788:Thalamus / Q000601:surgery
D000318:Adrenergic beta-Agonists; D000927:Anticonvulsants; D014150:Antipsychotic Agents; D001569:Benzodiazepines; D001905:Botulinum Toxins