Evidence-based guideline update: Treatment of essential tremor

  • Zesiewicz T
  • Elble R
  • Louis E
  • et al.
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Abstract

Background: This evidence-based guideline is an update of the 2005 American Academy of Neurology practice parameter on the treatment of essential tremor (ET). Methods: A literature review using MEDLINE, EMBASE, Science Citation Index, and CINAHL was performed to identify clinical trials in patients with ET published between 2004 and April 2010. Results and Recommendations: Conclusions and recommendations for the use of propranolol, primidone (Level A, established as effective); alprazolam, atenolol, gabapentin (monotherapy), sotalol, topiramate (Level B, probably effective); nadolol, nimodipine, clonazepam, botulinum toxin A, deep brain stimulation, thalamotomy (Level C, possibly effective); and gamma knife thalamotomy (Level U, insufficient evidence) are unchanged from the previous guideline. Changes to conclusions and recommendations from the previous guideline include the following: 1) levetiracetam and 3,4-diaminopyridine probably do not reduce limb tremor in ET and should not be considered (Level B); 2) flunarizine possibly has no effect in treating limb tremor in ET and may not be considered (Level C); and 3) there is insufficient evidence to support or refute the use of pregabalin, zonisamide, or clozapine as treatment for ET (Level U). AAN= : American Academy of Neurology; DBS= : deep brain stimulation; ET= : essential tremor; FTM= : Fahn-Tolosa-Marin; TRS= : Tremor Rating Scale

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Zesiewicz, T. A., Elble, R. J., Louis, E. D., Gronseth, G. S., Ondo, W. G., Dewey, R. B., … Weiner, W. J. (2011). Evidence-based guideline update: Treatment of essential tremor. Neurology, 77(19), 1752–1755. https://doi.org/10.1212/wnl.0b013e318236f0fd

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