Practical NeurologyTreatment of Essential Tremor

A Comprehensive Review of Essential Tremor, its Underlying Mechanisms, and the Latest Therapeutic Approaches

Essential tremor (ET) is a prevalent neurologic condition that poses significant challenges in terms of understanding its pathophysiology and managing its symptoms. This article provides a detailed overview of ET, shedding light on its complex nature and the various treatment options currently available.

HCN Medical Memo
As healthcare professionals, it’s crucial to stay updated on the latest research and treatment options for conditions like ET. Although propranolol remains the gold standard for treatment, other therapies are emerging that may offer additional options for patient care. Understanding the complex nature of ET can help guide treatment decisions and improve patient outcomes.

Key Points

• ET affects 1.3% of the population, increasing with age.
• The pathophysiology of ET is not fully understood due to its heterogeneous presentation.
• Genetic and environmental influences play a role in the development of ET.
• Propranolol is the first line of treatment for ET and the only therapy approved by the FDA.

The prevalence of essential tremor (ET) increases with age. In younger adults aged 20-40 years, the prevalence is approximately 0.04%. The prevalence increases to about 3.1% in middle-aged adults (40-60 years). However, it’s important to note that ET can start at any age from adolescence onwards.

Additional Points

• Other treatments include primidone, topiramate, gabapentin, other beta-blockers, benzodiazepines, nimodipine, botulinum toxin, and neuromodulation.
• Between 30% and 50% of individuals treated with pharmacologic agents will experience no amelioration of their tremor.

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