Essential Tremor: Update of Therapeutic Strategies

Med Clin (Barc). 2024 Jun 28;162(12):599-605. doi: 10.1016/j.medcli.2023.12.013. Epub 2024 Mar 28.
[Article in English, Spanish]

Abstract

In the last decades there has been progress in the treatment of essential tremor (TE) especially in the surgical field and to a lesser extent in the pharmacological field. We carry out a review of the currently available treatments. The first intervention is the use of non-pharmacological and non-surgical strategies (general advice, occupational therapy, speech therapy, psychotherapy). With discrete advances, the pharmacological treatment is not very satisfactory. Only 30-60% of patients have a positive response, and in these the anti-tremor effectiveness is 40-60%. The first-line drugs are still propranolol and primidone. In cases with severe tremor we will consider a surgical option, the method of choice being thalamotomy using high-intensity focused ultrasound. In the future we must continue to study the pathophysiology of TE, develop drugs specifically designed for TE and improve the technology of available invasive techniques.

Keywords: Deep brain stimulation; Essential tremor; Essential tremor treatment; Estimulación cerebral profunda; Gamma knife; High intensity focused ultrasound; Radiocirugía; Temblor esencial; Temblor esencial tratamiento; Ultrasonidos focales de alta intensidad.

Publication types

  • Review

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Anticonvulsants / therapeutic use
  • Essential Tremor* / drug therapy
  • Essential Tremor* / therapy
  • High-Intensity Focused Ultrasound Ablation
  • Humans
  • Primidone / therapeutic use
  • Propranolol / therapeutic use
  • Thalamus

Substances

  • Propranolol
  • Primidone
  • Anticonvulsants
  • Adrenergic beta-Antagonists