scholarly journals Medical Treatment of Essential Tremor

2014 ◽  
Vol 6 ◽  
pp. JCNSD.S13570 ◽  
Author(s):  
Ali H. Rajput ◽  
Alex Rajput
Keyword(s):  
Drug Treatment ◽  
Medical Treatment ◽  
Essential Tremor ◽  
Upper Limb ◽  
Postural Tremor ◽  
Alcoholic Drink ◽  
Kinetic Tremor ◽  
Effective Drugs ◽  
Pathological Tremor ◽  
Biochemical Abnormalities

Essential tremor (ET) is the most common pathological tremor characterized by upper limb action—postural tremor (PT)/kinetic tremor (KT). There are no specific neuropathological or biochemical abnormalities in ET. The disability is consequent to amplitude of KT, which may remain mild without handicap or may become disabling. The most effective drugs for sustained tremor control are propranolol and primidone. Symptomatic drug treatment must be individualized depending on the circumstances that provoke the tremor-related disability. Broad guidelines for treatment are discussed in this review. Patients may be treated intermittently only on stressful occasions with propranolol, clonazepam, or primidone monotherapy, or an alcoholic drink. Those with persistently disabling tremor need continued treatment.

scholarly journals Quantitative measures of postural tremor at the upper limb joints in patients with essential tremor

2020 ◽  
Vol 28 ◽  
pp. 499-507
Author(s):  
Do-Young Kwon ◽  
Yu-Ri Kwon ◽  
Yoon-Hyeok Choi ◽  
Gwang-Moon Eom ◽  
Junghyuk Ko ◽  
...  
Keyword(s):  
Essential Tremor ◽  
Upper Limb ◽  
Postural Tremor

Tremor

2020 ◽  
pp. 7-44
Author(s):  
Hiroshi Shibasaki ◽  
Mark Hallett ◽  
Kailash P. Bhatia ◽  
Stephen G. Reich ◽  
Bettina Balint
Keyword(s):  
Physiological Tremor ◽  
Postural Tremor ◽  
Isotonic Contraction ◽  
Resting Tremor ◽  
Efferent Pathway ◽  
Kinetic Tremor ◽  
Antagonist Muscles ◽  
Agonist And Antagonist ◽  
Agonist And Antagonist Muscles ◽  
Pathological Tremor

Tremor is broadly classified into physiological tremor and pathological tremor. Depending on the clinical features and the predominant pattern of production, tremor is classified into resting tremor, postural tremor, and kinetic tremor. Tremor is associated with rhythmic contraction of agonist and antagonist muscles, either alternately or simultaneously. Tremor involving muscles in the resting condition is called resting tremor and is seen most commonly in Parkinson disease. Tremor involving muscles during isometric contraction is called postural tremor, and it is most commonly seen in essential tremor. Tremor involving muscles during intended movements (isotonic contraction) is called kinetic tremor, and it is most commonly seen in a lesion of the cerebellar efferent pathway.

Can Resistance Training Improve Upper Limb Postural Tremor, Force Steadiness and Dexterity in Older Adults? A Systematic Review

2019 ◽  
Vol 49 (8) ◽  
pp. 1199-1216
Author(s):  
Justin W. L. Keogh ◽  
Sinead O’Reilly ◽  
Ethan O’Brien ◽  
Steven Morrison ◽  
Justin J. Kavanagh
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Resistance Training ◽  
Upper Limb ◽  
Postural Tremor ◽  
Force Steadiness

The effect of inertial loading on wrist postural tremor in essential tremor

2009 ◽  
Vol 120 (5) ◽  
pp. 1020-1029 ◽  
Author(s):  
M.E. Héroux ◽  
G. Pari ◽  
K.E. Norman
Keyword(s):  
Essential Tremor ◽  
Postural Tremor ◽  
Inertial Loading

Three-year follow-up of prospective trial of focused ultrasound thalamotomy for essential tremor

Neurology ◽  
2019 ◽  
Vol 93 (24) ◽  
pp. e2284-e2293 ◽  
Author(s):  
Casey H. Halpern ◽  
Veronica Santini ◽  
Nir Lipsman ◽  
Andres M. Lozano ◽  
Michael L. Schwartz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Essential Tremor ◽  
Focused Ultrasound ◽  
Rating Scale ◽  
Prospective Trial ◽  
Postural Tremor ◽  
Hand Tremor

ObjectiveTo test the hypothesis that transcranial magnetic resonance–guided focused ultrasound (tcMRgFUS) thalamotomy is effective, durable, and safe for patients with medication-refractory essential tremor (ET), we assessed clinical outcomes at 3-year follow-up of a controlled multicenter prospective trial.MethodsOutcomes were based on the Clinical Rating Scale for Tremor, including hand combined tremor–motor (scale of 0–32), functional disability (scale of 0–32), and postural tremor (scale of 0–4) scores, and total scores from the Quality of Life in Essential Tremor Questionnaire (scale of 0–100). Scores at 36 months were compared with baseline and at 6 months after treatment to assess for efficacy and durability. Adverse events were also reported.ResultsMeasured scores remained improved from baseline to 36 months (all p < 0.0001). Range of improvement from baseline was 38%–50% in hand tremor, 43%–56% in disability, 50%–75% in postural tremor, and 27%–42% in quality of life. When compared to scores at 6 months, median scores increased for hand tremor (95% confidence interval [CI] 0–2, p = 0.0098) and disability (95% CI 1–4, p = 0.0001). During the third follow-up year, all previously noted adverse events remained mild or moderate, none worsened, 2 resolved, and no new adverse events occurred.ConclusionsResults at 3 years after unilateral tcMRgFUS thalamotomy for ET show continued benefit, and no progressive or delayed complications. Patients may experience mild degradation in some treatment metrics by 3 years, though improvement from baseline remains significant.Clinicaltrials.gov identifierNCT01827904.Classification of evidenceThis study provides Class IV evidence that for patients with severe ET, unilateral tcMRgFUS thalamotomy provides durable benefit after 3 years.

scholarly journals Clinical Differentiation of Essential Tremor and Parkinson's Disease

2013 ◽  
Vol 6 ◽  
pp. CCRep.S11903 ◽  
Author(s):  
Robert Fekete ◽  
Jin Li
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Essential Tremor ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Postural Tremor ◽  
Arm Swing ◽  
Rest Tremor ◽  
Dopaminergic Terminal

We present clinical features and tremor characterization in a patient with Parkinson's disease (PD) as well as in two cases of essential tremor (ET) with some parkinsonian features but no evidence of dopaminergic terminal loss on 123I-FP-CIT Single Photon Emission Computed Tomography (SPECT). Relatively slow frequency rest tremor and bilateral upper extremity bradykinesia without decrementing amplitude were observed in the ET cases, with unilaterally decreased arm swing in case 3. Alternating rest tremor and re-emergent tremor with 13 second latency was confirmed in the PD case. Re-emergent tremor had alternating characteristics, which to our knowledge has not been previously reported. The ET cases had synchronous postural tremor. Alternating re-emergent tremor in PD provides further evidence for re-emergent tremor as an analogue of rest tremor in PD. Two cases of ET with synchronous postural tremor and one to two year history of parkinsonian features had no evidence of dopaminergic terminal loss up to 40 years after the initial onset of ET. Tremor synchronicity characterization can assist in differential diagnosis between the two disorders.

scholarly journals When the Brain Leaves the Scanner and Enters the Clinic

2018 ◽  
Vol 45 (3) ◽  
pp. 227-243 ◽  
Author(s):  
Anthony Barnett ◽  
Ella Dilkes-Frayne ◽  
Michael Savic ◽  
Adrian Carter
Keyword(s):  
Drug Treatment ◽  
Medical Treatment ◽  
Neural Basis ◽  
Treatment Providers ◽  
Immoral Behavior ◽  
Brain Recovery ◽  
Different Types ◽  
Moral Condition ◽  
Moral Discourses ◽  
The Brain

Addiction neuroscience promises to uncover the neural basis of addiction by mapping changes in the “diseased brains” of people with “drug addictions.” It hopes to offer revolutionary treatments for addiction and reduce the stigma experienced by those seeking treatment for a medical, rather than moral, condition. While the promises of addiction neuroscience have received considerable attention, relatively few studies have examined how neuroscientific discourses and promises play out in drug treatment settings. Instead of asking how neuroscience might measure or treat a preexisting addiction “problem,” we draw on poststructuralist ideas to trace how neuroscientific discourses produce addiction as a certain type of “problem” and the effects of these particular problematizations. Based on interviews with a range of different types of treatment providers working in Victoria, Australia, we discuss three themes that reveal neuroscientific discourses at work: (1) constituting pathological subjects, (2) neuroplasticity and “recovery,” and (3) the alleviation of guilt and shame via references to the “diseased brain.” On the basis of our analysis, we argue that dominant neuroscientific discourses produce patients as pathologized subjects, requiring medical treatment. We also contend that the intersection of neuroscientific and recovery discourses enacts “recovery” in terms of brain “recovery” through references to neuroplasticity. Further, when neuroscientific and moral discourses intersect, addicted subjects are absolved from the guilt associated with immoral behavior emerging from a “hijacked brain.” We conclude by emphasizing the need for future critical work to explore the complex ways in which neuroscientific discourses operate in localized care ecologies.

scholarly journals Tolerability and Efficacy of Customized IncobotulinumtoxinA Injections for Essential Tremor: A Randomized, Double-Blind, Placebo-Controlled Study

Toxins ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 807
Author(s):  
Mandar Jog ◽  
Jack Lee ◽  
Astrid Scheschonka ◽  
Robert Chen ◽  
Farooq Ismail ◽  
...  
Keyword(s):  
Essential Tremor ◽  
Upper Limb ◽  
Motor Performance ◽  
Controlled Study ◽  
Tolerability Profile ◽  
Double Blind ◽  
Hand Tremor ◽  
Global Impression Of Change ◽  
Amplitude Versus ◽  
Favorable Tolerability Profile

In this first, double-blind, randomized, placebo-controlled exploratory trial, we evaluate the efficacy and safety of incobotulinumtoxinA and feasibility of using kinematic tremor assessment to aid in the planning of muscle selection in a multicenter setting. Reproducibility of the planning technology to other clinical sites was explored. In this trial (NCT02207946), patients with upper-limb essential tremor (ET) were randomized 2:1 to a single treatment cycle of incobotulinumtoxinA or placebo. A tremor kinematic analytics investigational device was used to define a customized muscle set for injection, related to the pattern of the wrist, forearm, elbow, and shoulder tremor for each patient, and the incobotulinumtoxinA dose per muscle (total ≤ 200 U). Fahn–Tolosa–Marin (FTM) Part B motor performance score, Global Impression of Change Scale (GICS), and kinematic analysis-based efficacy evaluations were assessed. Thirty patients were randomized (incobotulinumtoxinA, n = 19; placebo, n = 11). FTM motor performance scores showed greater improvement with incobotulinumtoxinA versus placebo at Week 4 (p= 0.003) and Week 8 (p= 0.031). The physician-rated GICS score indicated improvement with incobotulinumtoxinA versus placebo at Week 4 (p < 0.05). IncobotulinumtoxinA also decreased accelerometric hand-tremor amplitude versus placebo from baseline to Week 4 (p= 0.004) and Week 8 (p < 0.001), with persistent tremor reduction up to 24 weeks post-injection. IncobotulinumtoxinA produced a slight and transient reduction of maximal grip strength versus placebo; two patients reported localized finger muscle weakness. Customized incobotulinumtoxinA injections decreased tremor severity and improved hand motor function in patients with upper-limb ET after a single injection cycle, with a favorable tolerability profile. The study showed that tremor kinematic analytics technology could be successfully scaled for use in other clinical sites.

scholarly journals Research on Characteristics of Essential Tremor in the Latvian Population / Esenciālā Tremora Īpatnību Izpēte Latvijas Populācijā

2015 ◽  
Vol 69 (5) ◽  
pp. 259-264
Author(s):  
Ligita Smeltere ◽  
Elvīra Smeltere
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Movement Disorder ◽  
Essential Tremor ◽  
Severe Form ◽  
Progressive Development ◽  
Kinetic Tremor

Abstract Essential tremor (ET) is a common movement disorder, characterised by symptoms such as bilateral postural and kinetic tremor with prevalent manifestation in hands. The disease has chronic progressive development. In the case of continuous severe form it may resemble Parkinson’s disease (PD) and sometimes comorbidity with PD is possible. Although both diseases have different pathogenesis and treatment, some tremor characteristics for both are similar, thus causing difficulties and mistakes in diagnosing. The aim of the research was to determine ET characteristics within the Latvian population to identify possible causes for making mistakes.

scholarly journals Correlates Between Force and Postural Tremor in Older Individuals with Essential Tremor

2015 ◽  
Vol 15 (6) ◽  
pp. 688-695 ◽  
Author(s):  
Justin J. Kavanagh ◽  
Justin W.L. Keogh
Keyword(s):  
Essential Tremor ◽  
Older Individuals ◽  
Postural Tremor
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