Essential Tremor Questions & Answers

Updated: Oct 22, 2018
  • Author: Deborah A Burke, MD; Chief Editor: Selim R Benbadis, MD  more...
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Questions & Answers

Overview

When are lab studies indicated for the diagnosis of essential tremor?

What is essential tremor?

How is essential tremor differentiated from other disorders?

What are the signs and symptoms of essential tremor?

How is essential tremor diagnosed?

What is the role of imaging in the diagnosis of essential tremor?

What is the role of MRI in the diagnosis of essential tremor?

What is the role of single-photon emission CT (SPECT) using 123I-ioflupain (DaTSCAN) in the diagnosis of essential tremor?

Which medications are used as maintenance therapy for the essential tremor?

What are the treatment options for essential tremor only requiring intermittent tremor reduction?

What is the role of alcohol in the treatment of essential tremor?

Which medications are used in the management of essential tremor?

What is the role of surgery in the treatment of essential tremor?

What is essential tremor?

What are the Movement Disorders Society inclusion criteria for diagnosis of essential tremor?

What are the Movement Disorders Society exclusion criteria for diagnosis of essential tremor?

What is the relationship between essential tremor and Parkinson disease?

What is the association between essential tremor and dystonia?

What is the role of glucose in the etiology of essential tremor?

What is the pathophysiology of essential tremor?

What is the role of harmane, a heterocyclic amine (HCA), in the etiology of essential tremor?

What is the evidence for and against categorizing essential tremor as a neurodegenerative disease?

What is the role of genetics in the etiology of essential tremor?

What are the susceptibility loci associated with the etiology of essential tremor?

What is the evidence that essential tremor is an alternative phenotype of a mutation causing parkinsonism?

What is the incidence of essential tremor in the US?

What is the global prevalence of essential tremor?

What are the racial predilections for essential tremor?

How does the incidence of essential tremor vary by sex?

How does the prevalence of essential tremor vary by age?

What are the mortality rates for essential tremor?

What is the likelihood of disability from essential tremor?

What are the causes of decreased quality of life in patients with essential tremor?

Presentation

Which history is characteristic of essential tremor?

How are essential tremor and enhanced physiologic tremor distinguished?

What is the relationship between dementia and essential tremor?

How is essential tremor described?

How is essential tremor characterized?

What are the physical findings characteristic of essential tremor?

DDX

Which conditions should be included in the differential diagnoses of essential tremor?

Which drugs can induce tremors and should be considered in the differential diagnoses for essential tremor?

Which metabolism-related tremors should be included in the differential diagnoses for essential tremor?

Which toxins can induce tremors and should be considered in the differential diagnoses for essential tremor?

What are the differential diagnoses for Essential Tremor?

Workup

What are the biologic markers for essential tremor?

Which lab tests are performed in the evaluation of essential tremor?

What is the role of electromyography and accelerometry in the evaluation of essential tremor?

What is the role of imaging in the diagnosis of essential tremor?

What is the role of single-photon emission CT (SPECT) using ioflupain 123 I (DaTSCAN) in the diagnosis of essential tremor?

What is the role of midbrain ultrasonography in the diagnosis of essential tremor?

What is the role of the tremor stability index in the diagnosis of essential tremor?

Treatment

What is the role of primidone and propranolol in the treatment of essential tremor?

What is the treatment for intermittent tremor reduction in essential tremor?

When is surgery indicated in the treatment of essential tremor?

What is the role of bilateral thalamotomy in the treatment of essential tremor?

What is the role of thalamic stimulation in the treatment of essential tremor?

What is the efficacy of primidone for the treatment of essential tremor?

What is primidone's mechanism of action in the treatment of essential tremor?

How is treatment selected for daily maintenance of essential tremor?

What is the alternative treatment for essential tremor when propranolol is contraindicated?

How is primidone or propranolol administered in the treatment of essential tremor?

What are the treatment options for mild essential tremor?

What is the efficacy of propranolol in the treatment of essential tremor?

What are the adverse effects of primidone in the treatment of essential tremor?

What is the AAN recommendation for use of primidone in essential tremor?

What is the AAN recommendation for use of topiramate in essential tremor?

What is the effectiveness of topiramate in the treatment of essential tremor?

What is alcohol's mechanism of action in the treatment of essential tremor?

What is the evidence base supporting use of less common medications for the treatment of essential tremor?

What is the effectiveness of clozapine in the treatment of essential tremor?

What is the AAN recommendation for use of clozapine in the treatment of essential tremor?

What is the AAN recommendation for use of mirtazapine in the treatment of essential tremor?

What is the AAN recommendation for use of gabapentin in the treatment of essential tremor?

What is the AAN recommendation for use of botulinum toxin in the treatment of essential tremor?

What is the effectiveness of mirtazapine in the treatment of essential tremor?

What is the effectiveness of gabapentin in the treatment of essential tremor?

What is the effectiveness of benzodiazepines in the treatment of essential tremor?

What are the AAN recommendations for use of benzodiazepines in the treatment of essential tremor?

What is the effectiveness of botulinum toxin in the treatment of essential tremor?

What is the effectiveness of thalamotomy in the treatment of essential tremor?

What are the potential adverse effects of thalamotomy in the treatment of essential tremor?

What is the effectiveness of unilateral thalamic stimulation in the treatment of essential tremor?

What is the effectiveness of bilateral thalamic stimulation in the treatment of essential tremor?

How do the outcomes of thalamotomy compare with that of thalamic stimulation in the treatment of essential tremor?

What are the adverse effects of thalamotomy in the treatment of essential tremor?

What are the benefits of thalamic stimulation in the treatment of essential tremor?

How does the functional status of patients with essential tremor compare following thalamotomy or thalamic stimulation?

What are the rates of stimulator reoperations following thalamic stimulation for essential tremor?

How does the efficacy of gamma knife thalamotomy compare with open surgical techniques for the treatment of essential tremor?

What are the advantages and disadvantages of thalamic stimulation for the treatment of essential tremor?

What is included in the follow-up of essential tremor?

Medications

What are the first-line medical treatments for essential tremor?

What are the second-line medical treatments for essential tremor?

Which medications in the drug class Antidepressants, Other are used in the treatment of Essential Tremor?

Which medications in the drug class Antipsychotics, 2nd Generation are used in the treatment of Essential Tremor?

Which medications in the drug class Anticonvulsants, Other are used in the treatment of Essential Tremor?

Which medications in the drug class Beta-Blockers, Nonselective are used in the treatment of Essential Tremor?