Columbia University Medical Center

New Guideline for Treatment of Essential Tremor

The American Academy of Neurology has released a new guideline on the treatment of essential tremor (ET), co-authored by Elan D. Louis, MD, MS, professor of neurology and epidemiology in the Department of Neurology, the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and the Gertrude H. Sergievsky Center.

ET is the most common tremor disorder. Often mistaken for Parkinson’s disease, it usually develops after the age of 40 and affects daily activities such as writing, eating, and speaking. Limited understanding of its cause hampers effective treatment.

According to the “Evidence-based guideline update: Treatment of essential tremor: Report of the Quality Standards Subcommittee of the American Academy of Neurology,” the most effective drugs for ET are still propranolol, a high blood pressure drug, and primidone, an anti-convulsant drug. Unfortunately, 30 ? 50 percent of patients do not respond to either drug. The guideline also discusses other drugs and surgery. The guideline no longer recommends use of the anti-convulsant drugs levetiracetam and flunarizine or the drug 3,4-diaminopyridine (used to treat rare muscle diseases) for arm and leg tremors.

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