Treatment of cerebellar tremor

Abstract

A patient with genetically confirmed spinocerebellar ataxia (type 2) presented with a 6-year history of progressive trunk and upper extremity action tremor with a rotatory component. The tremor interfered with many activities of daily living. Adaptive utensils and wrist weights were tried. Propranolol and amantadine gave the best pharmacologic control; however, primidone and clonazepam use was limited by side effects. Unfortunately there are currently no FDA-approved drugs for cerebellar ataxia, and all agents used to manage cerebellar tremor are “off-label” and are supported by limited evidence.