[Therapeutical strategies for essential tremor].
Essential tremor is the most common adult movement disorder. Traditionally considered as a benign disease, it can cause an important physical and psychosocial disability. Drug treatment remains poor and often unsatisfactory. Current therapeutical strategies are reviewed according to the level of discomfort caused by tremor: mild tremor, non-pharmacological strategies, alcohol, acute pharmacological therapy; moderate tremor, pharmacological therapies (propranolol, gabapentin, primidone, topiramate, alprazolam and other drugs), and severe tremor, the role of functional surgery is emphasized (thalamic deep brain stimulation, thalamotomy). It is also described the more specific treatment of head tremor with the use botulinum toxin. Finally, several points are exposed to guide the immediate research of this disease in near future.
Gironell
Alexandre
A
Unidad de Trastorno del Movimiento, Servicio de Neurología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España. agironell@santpau.es
D000328:Adult; D000368:Aged; D000525:Alprazolam / Q000009:adverse effects / Q000627:therapeutic use; D000588:Amines / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000627:therapeutic use; D046690:Deep Brain Stimulation; D020329:Essential Tremor / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077206:Gabapentin; D019416:Head Movements; D006801:Humans; D008875:Middle Aged; D011324:Primidone / Q000009:adverse effects / Q000627:therapeutic use; D011433:Propranolol / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index; D013788:Thalamus / Q000503:physiopathology / Q000601:surgery; D000077236:Topiramate; D014149:Tranquilizing Agents / Q000627:therapeutic use; D014832:Voice Disorders / Q000188:drug therapy / Q000209:etiology; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000627:therapeutic use
D000588:Amines; D014150:Antipsychotic Agents; D002121:Calcium Channel Blockers; D003509:Cyclohexanecarboxylic Acids; D014149:Tranquilizing Agents; D000077236:Topiramate; D011324:Primidone; D005632:Fructose; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D011433:Propranolol; D019274:Botulinum Toxins, Type A; D000525:Alprazolam