Essential tremor (ET) is an involuntary movement disorder of unknown cause that lacks a specific set of diagnostic criteria. In addition, pharmacologic treatment is modest, with only one FDA-approved drug and one off-label agent. This condition was believed to be benign, nothing more than a disruption of daily activities and a source of embarrassment. However, recent studies have demonstrated the evolution of ET in many areas. This review discusses the causes, prevalence, diagnosis, and current pharmacologic treatment of ET. In addition, some lifestyle modifications for ET are discussed. ET, one of the most common movement disorders, is more prevalent than Parkinson’s disease, affecting between 0.4% and 6% of the population worldwide. When essential tremor (ET) often prevents with daily activities, long-term drug treatment is needed. Your healthcare provider will determine which treatment is best based on other medical conditions you may have and based on the safety of the drugs. The goal is to minimize the side effects of drugs while having improvement in function. With the use of medication, patients may see improvement in the ability to control tremor and improvement in functions like drinking from a cup or using food utensils. More specialized motor functions, such as being able to thread a needle, may not improve. For patients with mild ET, the effects of the condition can be lessened by the patient’s minimizing exposure to emotional stress and avoiding substances, such as caffeine and nicotine that may increase tremor. In social situations, a person with mild tremor can take a beta blocker drug (see below) or drink a small amount of alcohol if such treatments are approved by a doctor.
When Essential Tremor significantly interferes with daily activities, long-term drug treatment is needed. Drugs most commonly used to treat the condition include beta-blockers (propranolol) and an epilepsy drug called primidone (Mysoline). Topiramate (Topamax), another drug used to treat epilepsy and migraine, helps some people. With the use of medication, people with essential tremor may see improvement in their ability to control their tremor and improvement in activities such as drinking from a cup or using food utensils. More specialized motor functions, such as being able to thread a needle, may still be too difficult. However, for most people, essential tremor is not disabling. Your health care provider will determine which treatment is best for you based on your medical history. When essential tremor (ET) is early and mild, symptoms generally don’t interfere with daily tasks. If symptoms worsen, medication may be prescribed to reduce the speed (frequency) and amplitude (size) of motion. One type of drug used to control ET is called a beta blocker. As the name suggests, the action of the drug blocks the effect of adrenaline on specific receptors. One type is used after a heart attack to reduce risk of another attack. Others are used to regulate abnormal heart rhythm (arrhythmia) or lower blood pressure. A type that opens up blood vessels may help lessen migraine headaches. One particular beta blocker, propranolol, is used to control ET and is usually the first choice for younger patients.
Tremor is defined as a rhythmic, involuntary, oscillating movement of a body part occurring in isolation or as part of a clinical syndrome. In clinical practice, characterization of tremor is important for etiologic consideration and treatment. Common types include resting tremor, postural tremor, kinetic tremor, task-specific tremor, and intention tremor. Resting tremor occurs when a body part is at complete rest against gravity. Postural tremor occurs during maintenance of a position against gravity and increases with action. Tremor amplitude decreases with voluntary activity. Action or kinetic tremor occurs during voluntary movement. Box 2 lists examples of postural and action tremors. Task-specific tremor emerges during a specific activity. Intention (or terminal) tremor manifests as a marked increase in tremor amplitude during a terminal portion of targeted movement. Your doctor might order a magnetic resonance imaging (MRI) scan or a computerized axial tomography (CAT) scan if there is a suspicion of some other cause of tremor. Here are some questions you may be asked: A brain scan is not required to diagnose ET. During your physical exam, your doctor will be gathering as much information as possible about your tremor. Doctors who are trained to evaluate tremor can accurately diagnose ET on the basis of the symptoms and a neurological examination. Before making a diagnosis of ET, your doctor may want to investigate other possible causes of tremor such as thyroid disease, excessive caffeine ingestion or medication side effects. Not everyone who inherits a gene develops symptoms, and some people have ET and do not have a family history of tremor, possibly suggesting other causes. The course of ET is variable and may be progressive over many decades. Can a diagnosis of ET be made from looking at a brain scan? Researchers have already located two genes that predispose to ET and are currently trying to locate others. No one group of people is more likely to develop ET. No one can predict how much your tremor will worsen with time. This means that each child of a parent with ET has approximately a 50% chance of inheriting a gene that causes ET. Though ET may first appear at any age between childhood and old age, onset is rare before the age of ten. ET is found in all races and in all parts of the world.
Tremor von den Ursachen über die Symptome und Diagnose bis zur Therapie in. nicht kardio-selektive Betablocker wie Propranolol oder Antiepileptika wie. When essential tremor ET is early and mild, symptoms generally don't. One particular beta blocker, propranolol, is used to control ET and is usually the first.