Essential tremor: diagnosis and management

BMJ : British Medical Journal
Vicki Shanker

Abstract

Essential tremor is one of the most common movement disorders in adults and can affect both children and adults. An updated consensus statement in 2018 redefined essential tremor as an isolated action tremor present in bilateral upper extremities for at least three years. Tremor may also be present in other locations, commonly the neck or the vocal cords. Patients with additional neurologic symptoms are now categorized as "essential tremor plus." Additional clinical features associated with the condition include but are not limited to cognitive impairment, psychiatric disorders, and hearing loss. When treatment is needed, propranolol and primidone are considered first line treatments. Patients who are severely affected are often offered deep brain stimulation. Although the ventral intermediate nucleus of the thalamus is the traditional surgical target, the caudal zona incerta is also being studied as a possible superior alternative. Magnetic resonance imaging guided high intensity focused ultrasound is a newer surgical alternative that may be ideal for patients with substantial medical comorbidities. Current research explores novel oral treatments, chemodenervation, and noninvasive neuromodulation for treatment of essential tre...Continue Reading

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Citations

Dec 22, 2019·Acta Neurologica Scandinavica·Hongyan HuangYanming Xu
Mar 21, 2020·CNS Neuroscience & Therapeutics·Ya-Ping YanGuo-Hua Zhao
Apr 30, 2020·Praxis·Markus F OertelLennart H Stieglitz
Sep 10, 2020·Journal of Neurophysiology·Angela NietzEsther Krook-Magnuson
Feb 17, 2021·Journal of Neuroengineering and Rehabilitation·Alejandro Pascual-ValduncielJosé L Pons
Feb 11, 2021·Anesthesiology Clinics·Lane CrawfordLetha Mathews
Aug 27, 2021·Frontiers in Neurology·Julio S Lora-MillanEduardo Rocon

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