essential tremor

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Epidemiology

  • 0.3-5.6% of the general population
  • men & women equally affected
  • prevalence increases with age
  • mean age at onset 35-45 years
    • most often appears in late adolescence or middle age
  • virtually always presents by age 70 years

Pathology

Genetics

Clinical manifestations

Laboratory

Radiology

Complications

Differential diagnosis

Management

* propranolol, primidone & topiramate most effective[2]

More general terms

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1015-16
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2021.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. 3.0 3.1 Physician's Desk Reference (PDR) 56th ed, 2002
  4. 4.0 4.1 4.2 4.3 Gironell A et al A randomized placebo-controlled comparative trial of gabapentin and propranolol in essential tremor. Arch of Neurol 56:475, 1999 PMID: https://www.ncbi.nlm.nih.gov/pubmed/10199338
    Harrison's Online, 2002
  5. Zesiewicz TA et al, CME Practice Parameter: Therapies for essential tremor Report of the Quality Standards Subcommittee of the American Academy of Neurology Neurology 2005;64:2008-2020 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/15972843 <Internet> http://www.neurology.org/cgi/reprint/64/12/2008.pdf?ck=nck
  6. 6.0 6.1 Putzke JD, Whaley NR, Baba Y, Wszolek ZK, Uitti RJ. Essential tremor: predictors of disease progression in a clinical cohort. J Neurol Neurosurg Psychiatry. 2006 Nov;77(11):1235-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17043291
  7. 7.0 7.1 Louis ED et al, A population-based study of mortality in essential tremor. Neurology 2007, 69:1982 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18025392
  8. 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 Zesiewicz TA et al Evidence-based guideline update: Treatment of essential tremor Report of the Quality Standards Subcommittee of the American Academy of Neurology Neurology, October 19, 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22013182 <Internet> http://www.neurology.org/content/early/2011/10/18/WNL.0b013e318236f0fd.abstract
    Evidence-based guideline update: Treatment of essential tremor Data Supplement http://www.neurology.org/content/early/2011/10/18/WNL.0b013e318236f0fd/suppl/DC1
  9. Prescriber's Letter 19(3): 2012 Drug Treatment for Essential Tremor Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=280336&pb=PRL (subscription needed) http://www.prescribersletter.com
  10. 10.0 10.1 Elias WJ et al. A pilot study of focused ultrasound thalamotomy for essential tremor. N Engl J Med 2013 Aug 15; 369:640. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23944301 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1300962
    FDA News Release. July 11, 2016 FDA approves first MRI-guided focused ultrasound device to treat essential tremor. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm510595.htm
  11. 11.0 11.1 Elias WJ et al A Randomized Trial of Focused Ultrasound Thalamotomy for Essential Tremor. N Engl J Med 2016; 375:730-739. August 25, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27557301 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1600159
    Louis ED Treatment of Medically Refractory Essential Tremor. N Engl J Med 2016; 375:792-793. August 25, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27557307 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1606517
  12. 12.0 12.1 George J Wrist-Worn Device Reduces Hand Tremor. Neuroperipheral therapy interrupts signal in essential tremor patients. MedPage Today. April 19, 2018 https://www.medpagetoday.com/meetingcoverage/aan/72445
    Pahwa R, et al Non-invasive peripheral nerve stimulation for symptomatic relief of hand tremor in essential tremor. American Academy of Neurology (AAN) 2018.
  13. Haubenberger D, Hallett M. Essential Tremor. N Engl J Med. 2018 May 10;378(19):1802-1810. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29742376 https://www.nejm.org/doi/full/10.1056/NEJMcp1707928
  14. 14.0 14.1 George J Dementia More Common in People With Essential Tremor. Prevalence greater than normal aging, but not as high as Parkinson's disease. MedPage Today March 6, 2024 https://www.medpagetoday.com/meetingcoverage/aan/109046
  15. 15.0 15.1 Ghanem A et al. Prevalence of and annual conversion rates to mild cognitive impairment and dementia: Prospective, longitudinal study of an essential tremor cohort. Ann Neurol 2024 Jun; 95:1193. https://onlinelibrary.wiley.com/doi/10.1002/ana.26927

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