TREATMENT OF ESSENTIAL TREMOR: RECENT EVIDENCE AND CLINICAL CHALLENGES
DOI:
https://doi.org/10.56238/levv16n52-078Keywords:
Essential Tremor, Pharmacological Treatment, Neuromodulation, Deep Brain Stimulation, Focused UltrasoundAbstract
Essential Tremor (ET) is the most common movement disorder, characterized by postural and kinetic tremor that can cause significant functional disability. Its pathophysiology is linked to dysfunction in the cerebello-thalamo-cortical circuit. This narrative review, based on a PubMed database search, summarizes the current evidence on the diagnosis and therapeutic approaches for ET. The diagnosis remains clinical, but advanced neuroimaging, such as DaTscan and functional and structural magnetic resonance imaging, plays a crucial role in the differential diagnosis and in understanding the mechanisms of the disease. Treatment is stepwise: first-line pharmacological therapy with propranolol and primidone offers symptomatic relief for 50–70% of patients, but many discontinue treatment due to lack of efficacy or adverse effects. For refractory cases, surgical interventions such as Deep Brain Stimulation (DBS) and Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) are highly effective. Non-invasive therapies, such as peripheral nerve stimulation, represent an emerging frontier. The management of ET requires a personalized approach, considering the severity of symptoms and the patient's profile to select the best therapeutic strategy.
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References
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