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[Tremor. Differential diagnosis and treatment].

Abstract
Tremor is one of the most frequent neurological signs; the diagnosis is mainly clinical. The most frequent tremor is essential tremor, which manifests itself as a postural and kinetic tremor. Tremor may occur not only in the hands, but also in the head and voice. Parkinsonian tremor is a tremor at rest; the legs and face are frequently involved. Orthostatic tremor mainly manifests itself in the legs and gives rise to postural instability. Dystonic tremor is an action tremor of the affected region of the body. Drug therapy mostly depends on the clinical manifestation. Postural and action tremors respond to beta blockers, primidone, some antiepileptics and benzodiazepines. Classical rest tremors are improved by dopaminergic substances or anticholinergics. Dystonic tremor may be successfully treated by injecting botulinum toxin. Orthostatic tremor responds to gabapentin or benzodiazepines in some patients. In patients with severely disability, implantation of thalamic stimulation electrodes may be considered.
AuthorsH Wilms, J Raethjen
JournalDer Nervenarzt (Nervenarzt) Vol. 79 Issue 8 Pg. 975-80; quiz 981 (Aug 2008) ISSN: 0028-2804 [Print] Germany
Vernacular TitleTremor. Differenzialdiagnose und Therapie.
PMID18618093 (Publication Type: English Abstract, Journal Article, Review)
Chemical References
  • Anticonvulsants
  • Primidone
  • Botulinum Toxins
Topics
  • Anticonvulsants (therapeutic use)
  • Botulinum Toxins (therapeutic use)
  • Deep Brain Stimulation (methods)
  • Diagnosis, Differential
  • Humans
  • Primidone (therapeutic use)
  • Tremor (diagnosis, therapy)

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