How to treat essential tremor, these treatments are the most common

Essential tremor, also known as essential tremor, is a familial genetic disease. It affects more males and is more likely to occur in young and elderly people. It needs to be treated as early as possible. You can choose medication, have regular check-ups, take good care of yourself in life, and maintain a good mood.

1. Antispasmodics and tranquilizers

(1) Primidone: It can reduce the amplitude of tremors but does not affect the frequency of tremors. Its mechanism is unknown. It is used to reduce hand tremors but has poor effect on head and tongue tremors. ET patients are often very sensitive to this drug and should not be used to treat epilepsy. Start with a low dose of 50 mg/d and increase the dose by 50 mg/d every 2 weeks until it is effective or side effects occur. Usually the effective dose is 100-150 mg, 3 times/d. To improve medication compliance and reduce drowsiness side effects, it is recommended to take the drug before bedtime. 20% to 30% of patients experience acute side effects such as dizziness, nausea and postural instability after taking the medicine. These side effects are temporary and can be gradually relieved without affecting continued medication.

(2) Antiepileptic drug gabapentin: Its use in the treatment of essential tremor remains controversial. Although several open-label studies have suggested that gabapentin is effective in reducing tremors, a double-blind controlled study did not find it to be any better than placebo.

(3) Neuroleptics: commonly used are phenobarbital, diazepam (Valium), etc. Recent studies suggest that clonazepam may have better therapeutic effects, with the main side effect being drowsiness. Anxiety can aggravate tremors, so it is speculated that the therapeutic mechanism may be related to central sedation.

2. Botulinum toxin A (BTX-A) can effectively reduce tremors of limbs, soft palate, etc. , reduce tremor amplitude, and has little effect on tremor frequency. One observational study showed that 75% of patients experienced mild to moderate relief of tremor after 4 weeks of injection of BTX-A 100U into the hand extensor and flexor muscles.

BTX-A can also treat primary speech tremor. Blitzer et al. injected BTX-A subcutaneously into the patient's vocal cords through the cricothyroid membrane. The vocal function of most patients was significantly improved, and some patients needed to be injected again into the sternohyoid muscle and sternothyroid muscle. Modugno reported that local intramuscular injection of BTX-A can effectively relieve tremors and muscle tension. The mechanism may be to act on peripheral nerve endings and block the release of the neurotransmitter acetylcholine. Attention should be paid to the individualization of injection dose and site.

3. Others

(1) Clozapine: It can effectively relieve the symptoms of essential tremor. However, it can cause granulocytopenia and lead to fatal infection. It is recommended to check blood cell counts weekly within 6 months after taking the drug, and then check every 2 weeks.

(2) Carbonic anhydrase inhibitor methazolamide

4. Diet and health care

1. Eat light food and pay attention to dietary regularity.

2. Eat a reasonable diet according to the doctor's advice.

3. This disease does not have any major dietary restrictions, so just eat a reasonable diet.