Population: Adults with essential tremor.
Organization
AAN 2011
Recommendations
–Treat with propranolol or primidone.
–Alternative treatment options include alprazolam, atenolol, gabapentin, sotalol, or topiramate. Favor non-benzodiazepine options due to risk of dependency and high side-effect profile.
–Do not use levetiracetam, pindolol, trazodone, acetazolamide, or 3,4-diaminopyridine.
Practice Pearls
• Essential tremor should be postural (occurs when body part is voluntarily maintained against gravity), symmetric, involving hands/wrists, lower extremities and head/voice. It tends to improve with a small amount of alcohol intake. Patients with intention tremor, unilateral/symmetric tremor, or rest tremor should be evaluated for alternative diagnoses.
• Unilateral thalamotomy may be effective for severe refractory essential tremors.
Sources
–http://www.neurology.org/content/77/19/1752.full.pdf+html
–Am Fam Physician. 2018;97(3):180-186.