Essential Tremor (Essential Tremors)

A relatively common disorder characterized by a fairly specific pattern of tremors which are most prominent in the upper extremities and neck, inducing titubations of the head. The tremor is usually mild, but when severe may be disabling. An autosomal dominant pattern of inheritance may occur in some families (i.e., familial tremor). (Mov Disord 1988;13(1):5-10)

Also Known As:

Networked: 854 relevant articles (100 outcomes, 140 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Tremor (Tremors)
2.	Parkinson Disease (Parkinson's Disease)
3.	Dystonia (Limb Dystonia)
4.	Movement Disorders (Movement Disorder)
5.	Obsessive-Compulsive Disorder (Disorder, Obsessive-Compulsive)

Experts

1.	Louis, Elan D: 31 articles (05/2015 - 11/2002)
2.	Okun, Michael S: 20 articles (01/2015 - 04/2005)
3.	Jankovic, Joseph: 16 articles (11/2015 - 11/2004)
4.	Foote, Kelly D: 16 articles (01/2015 - 04/2005)
5.	Alonso-Navarro, Hortensia: 14 articles (11/2015 - 01/2006)
6.	García-Martín, Elena: 12 articles (11/2015 - 01/2006)
7.	Benito-León, Julián: 12 articles (06/2015 - 01/2006)
8.	Zheng, Wei: 12 articles (09/2014 - 08/2007)
9.	Agúndez, José A G: 11 articles (11/2015 - 01/2006)
10.	Deuschl, Günther: 11 articles (10/2015 - 06/2007)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Essential Tremor:

1.	Propranolol (Inderal)FDA LinkGeneric 02/01/1983 - "These results indicate that a single oral dose of propranolol is effective in producing a rapid and marked reduction of essential tremor. " 05/01/1990 - "Clinical and computer-based assessment of long-term therapeutic efficacy of propranolol in essential tremor." 11/06/1976 - "In a double-blind crossover study 12 patients with essential tremor were treated with propranolol and a placebo; 8 improved with propranolol and 3 with the placebo; the degree of improvement with propranolol was greater. " 11/06/1975 - "Peripheral beta-adrenergic tremorogenic receptors function normally even in patients with essential tremor; their function is not necessary for the production of essential tremor, and the efficacy of chronic propranolol therapy in the suppression of essential tremor is not mediated via its peripheral beta-adrenergic blocking action." 03/01/2004 - "The aim of our study is to report the clinical response to long action propranolol (LAP) of 40 patients diagnosed with essential tremor with no previous treatment. "
2.	Primidone (Sertan)FDA LinkGeneric 01/17/1981 - "Primidone is highly effective in benign familial tremor. " 09/01/1985 - "Uncontrolled clinical studies have suggested that primidone may be effective in reducing essential tremor thus providing a valuable alternative to beta-adrenoreceptor antagonists which are currently the drugs of first choice. " 02/01/1990 - "The long-term efficacy of primidone (375-750 mg/day) in essential tremor was evaluated prospectively in 11 patients who had shown a favorable response to 4-week treatment with the drug under placebo-controlled conditions. " 01/01/1986 - "Primidone is an effective agent for the treatment of essential tremor." 07/01/2012 - "Primidone is a minor first-generation antiepileptic drug, little currently prescribed for this indication, but except marketing authorization, remains a first-line treatment of essential tremor. "
3.	topiramate (Topamax)FDA LinkGeneric 03/14/2006 - "In small trials, topiramate appeared to be beneficial in essential tremor. " 09/01/2006 - "Is the anticonvulsant topiramate beneficial in essential tremor?" 03/14/2006 - "Topiramate was effective in the treatment of moderate to severe essential tremor. " 11/01/2003 - "Low doses of topiramate are effective in essential tremor: a report of three cases." 03/01/2006 - "The antiepileptic drug topiramate has been reported to improve essential tremor, but clinical trials have been small and of unsatisfactory design. "
4.	gabapentin (Neurontin)FDA LinkGeneric 05/01/1998 - "Gabapentin has been reported to be effective for essential tremor (ET) based on open-label trials. " 04/01/1999 - "Gabapentin may be useful for the treatment of essential tremor." 07/01/2000 - "Gabapentin for essential tremor: a multiple-dose, double-blind, placebo-controlled trial." 04/01/1999 - "To study the effects of gabapentin in a comparative, double-blind, crossover, placebo-controlled trial of patients who have essential tremor. " 05/01/1998 - "Double-blind controlled trial of gabapentin in essential tremor."
5.	Metoprolol (Lopressor)FDA LinkGeneric 07/01/1986 - "Metoprolol possesses the ability to blunt the tremorgenic response to mental stress in patients with essential tremor, but the duration of this effect lasts less than seven hours after administration of a dose." 07/01/1986 - "We have studied the ability of metoprolol tartrate to attenuate specifically the tremorgenic response to mental stress in five patients with essential tremor who were each studied on four occasions. " 07/01/1986 - "Attenuation of response to mental stress in patients with essential tremor treated with metoprolol." 09/01/1984 - "Data suggest that the alpha-hydroxymetabolite of metoprolol may contribute to the reduction in essential tremor." 11/28/1981 - "Metoprolol in essential tremor."
6.	Botulinum Toxins (Botulinum Toxin)IBA 01/01/2006 - "Botulinum toxin is effective for essential tremor of the voice and head. " 12/01/2000 - "This study aimed to improve botulinum toxin's (BTX) efficacy and to reduce its unwanted effects in the treatment of functional disability due to essential tremor (ET) of the hand. " 12/01/2000 - "Botulinum toxin treatment for functional disability induced by essential tremor." 08/01/1995 - "Several new drug treatments have been tried, but with limited success; the role of thalamic stimulation and botulinum toxin in the treatment of essential tremor remains to be judged." 08/01/2000 - "Botulinum toxin for essential tremor of the voice with multiple anatomical sites of tremor: a crossover design study of unilateral versus bilateral injection."
7.	pregabalin (Lyrica)FDA Link 02/01/2013 - "Multisite, double-blind, randomized, controlled study of pregabalin for essential tremor." 10/15/2009 - "Efficacy and tolerability of pregabalin in essential tremor: a randomized, double-blind, placebo-controlled, crossover trial." 08/15/2007 - "A pilot, double-blind, placebo-controlled trial of pregabalin (Lyrica) in the treatment of essential tremor." 01/01/2007 - "Pregabalin (Lyrica) in the treatment of essential tremor." 10/15/2009 - "We performed a double-blind, crossover-design study to assess the tolerability and efficacy of pregabalin (PGB) in patients with essential tremor (ET). "
8.	Alprazolam (Xanax)FDA LinkGeneric 02/01/1988 - "Efficacy of alprazolam for essential tremor." 02/01/1988 - "The effect of alprazolam on essential tremor was examined by a double-blind, placebo-controlled parallel study of 24 patients. " 01/01/2014 - "Effects of alprazolam on cortical activity and tremors in patients with essential tremor." 10/01/2006 - "A 40-year-old woman with a history of substance abuse complicated by essential tremor and neuropathic pain was admitted to our addictions unit with altered mental state due to escalating use of alprazolam. " 10/01/2006 - "Apparently, her essential tremor had responded inadequately to propranolol, but had responded well to alprazolam. "
9.	Prostaglandins B (PGB)IBA 10/15/2009 - "We performed a double-blind, crossover-design study to assess the tolerability and efficacy of pregabalin (PGB) in patients with essential tremor (ET). " 08/15/2007 - "We performed a pilot, double-blind, placebo-controlled, randomized trial to evaluate the efficacy and tolerability of pregabalin (PGB, Lyrica), an antiepileptic agent, in treating essential tremor (ET). " 01/01/2007 - "We report on 2 essential tremor patients who experienced marked improvement in upper extremity tremor with the use of pregabalin (Lyrica, PGB). "
10.	Sotalol (Sotalol Hydrochloride)FDA LinkGeneric 08/01/1983 - "Beta-adrenoreceptor mechanisms in essential tremor; a double-blind placebo controlled trial of metoprolol, sotalol and atenolol." 10/01/1979 - "Three different beta-adrenoreceptor antagonists--propranolol, sotalol, and atenolol--were compared in a double-blind study with placebo in nine patients with essential tremor. " 08/01/1983 - "In order to elucidate the mode of action of beta-adrenoreceptor antagonists in essential tremor, the efficacy of chronic oral administration of metoprolol, atenolol and sotalol was compared in a randomised, double-blind placebo controlled trial in twenty-four patients. " 10/01/1985 - "Propranolol and sotalol produced equal maximal inhibition of isoprenaline-induced tremor but propranolol was significantly more effective in reducing essential tremor. "

Therapies and Procedures

1.	Deep Brain Stimulation 03/01/2005 - "Deep brain stimulation is the best option for patients with disabling, drug-resistant essential tremor. " 05/01/2014 - "Deep brain stimulation (DBS) has proven to be a safe and effective therapy for refractory essential tremor, but information regarding long-term outcomes is lacking. " 08/01/2014 - "Chronic deep brain stimulation of the nucleus ventralis intermedius is an effective treatment for individuals with medication-resistant essential tremor. " 09/11/2013 - "Although thalamic deep brain stimulation is an effective treatment for patients with essential tremor, little is known about its effect on cortical neural dynamics. " 01/01/2013 - "Parkinsonian and essential tremor can often be effectively treated by deep brain stimulation. "
2.	Drug Therapy (Chemotherapy) 01/01/1995 - "In conclusion we regard Vim neurostimulation as an effective and safe alternative to conventional thalamotomy and recommend that it should be considered in cases in which drug therapy has failed to affect Parkinsonian or essential tremor. " 01/01/2013 - "Pharmacotherapy of essential tremor." 01/01/2008 - "Pharmacotherapy of essential tremor : an overview of existing and upcoming agents." 11/01/2007 - "This concept has broad implications for understanding the mechanism and designing rationale pharmacotherapy for abnormal oscillations and may be applicable to other common disorders in which there are no structural abnormalities in the brain such as essential tremor." 03/01/2005 - "This genetic animal model elucidates a mechanism of GABAergic dysfunction in the major motor pathway and potential targets for pharmacotherapy of essential tremor."
3.	Injections 06/01/2013 - "To assess the efficacy and safety of BoNT injections for the treatment of certain movement disorders, including blepharospasm, hemifacial spasm, oromandibular dystonia, cervical dystonia, focal limb dystonias, laryngeal dystonia, tics, and essential tremor, an expert panel reviewed evidence from the published literature. " 11/01/2010 - "This Review assesses the mechanisms of action of BoNT, and examines the use of BoNT injections in numerous neurological conditions, including dystonia, spasticity, headaches and other painful disorders, hemifacial spasm, essential tremor, motor tics, hyperhidrosis, and sialorrhea and drooling. " 01/01/1997 - "Thirty-seven patients with essential tremor were given intramuscular clonidine injections of 0.3 mg. Physical examination and statistical analysis showed that response was highly positive (t = 13.47; p < 0.0001) 60 min after administration. " 06/12/2001 - "Botulinum toxin type A injections for essential tremor of the hands resulted in significant improvement of postural, but not kinetic, hand tremors and resulted in limited functional efficacy. " 08/01/2014 - "Traditional approaches for neurological rehabilitation of patients affected with movement disorders, such as Parkinson's disease (PD), dystonia, and essential tremor (ET) consist mainly of oral medication, physical therapy, and botulinum toxin injections. "
4.	Activities of Daily Living (ADL) 01/01/2002 - "After thalamic DBS, health-related quality of life including disability in ADL and social life were improved in patients with essential tremor." 01/01/2013 - "The essential tremor interferes with a patient's daily living activity, because it may occur during a voluntary motion. " 08/01/2011 - "Essential tremor quantification during activities of daily living." 06/01/2003 - "The impact of thalamic stimulation on activities of daily living for essential tremor." 12/01/2008 - "To report long-term effects of thalamic deep brain stimulation (DBS) on activities of daily living (ADL) and health-related quality of life (HRQoL) in patients with essential tremor (ET). "
5.	Electrodes (Electrode) 07/01/2000 - "The goal in this study was to correlate the location of the electrodes with the clinical efficacy of DBS in a patient with essential tremor. " 12/01/2015 - "PD patients underwent electrode implantation in the subthalamic (STN) nucleus (3 patients) and pedunculopontine (PPTg) nucleus (5 patients), while 2 patients with essential tremor were implanted in the ventral intermediate nucleus (VIM) of the thalamus. " 01/01/2013 - "Twenty-eight patients with essential tremor (ET) implanted with 33 DBS electrodes were evaluated concerning stimulation-induced side effects by testing each contact separately one year after surgery. " 02/01/2008 - "Optimal electrode location for thalamic DBS in essential tremor corresponds to the anterior margin of the ventralis intermedius nucleus. " 05/01/2004 - "Optimal electrode location for thalamic DBS in essential tremor corresponds to the anterior margin of the ventralis intermedius nucleus. "