Advertisement

Drug Safety

, Volume 26, Issue 7, pp 461–481 | Cite as

Benefits and Risks of Pharmacological Treatments for Essential Tremor

  • Kelly E. Lyons
  • Rajesh PahwaEmail author
  • Cynthia L. Comella
  • Mahmood S. Eisa
  • Rodger J. Elble
  • Stanley Fahn
  • Joseph Jankovic
  • Jorge L. Juncos
  • William C. Koller
  • William G. Ondo
  • Kapil D. Sethi
  • Matthew B. Stern
  • Caroline M. Tanner
  • Ron Tintner
  • Ray L. Watts
Review Article

Abstract

Essential tremor can cause significant functional disability in some patients. The arms are the most common body part affected and cause the most functional disability. The treatment of essential tremor includes medications, surgical options and other forms of therapy. Presently there is no cure for essential tremor nor are there any medications that can slow the progression of tremor.

Treatment for essential tremor is recommended if the tremor causes functional disability. If the tremor is disabling only during periods of stress and anxiety, propranolol and benzodiazepines can be used during those periods when the tremor causes functional disability. The currently available medications can improve tremor in approximately 50% of the patients. If the tremor is disabling, treatment should be initiated with either primidone or propranolol. If either primidone or propranolol do not provide adequate control of the tremor, then the medications can be used in combination. If patients experience adverse effects with propranolol, occasionally other β-adrenoceptor antagonists (such as atenolol or metoprolol) can be used. If primidone and propranolol do not provide adequate control of tremor, occasionally the use of benzodiazepines (such as clonazepam) can provide benefit. Other medications that may be helpful include gabapentin or topiramate. If a patient has disabling head or voice tremor, botulinum toxin injections into the muscles may provide relief from the tremor. Botulinum toxin in the hand muscles for hand tremor can result in bothersome hand weakness and is not widely used. There are other medications that have been tried in essential tremor and have questionable efficacy. These drugs include carbonic anhydrase inhibitors (e.g. methazolamide), phenobarbital, calcium channel antagonists (e.g. nimodipine), isoniazid, clonidine, clozapine and mirtazapine.

If the patient still has disabling tremor after medication trials, surgical options are usually considered. Surgical options include thalamotomy and deep brain stimulation of the thalamus. These surgical options provide adequate tremor control in approximately 90% of the patients. Surgical morbidity and mortality for these procedures is low. Deep brain stimulation and thalamotomy have been shown to have comparable efficacy but fewer complications have been reported with deep brain stimulation. In patients undergoing bilateral procedures deep brain stimulation of the thalamus is the procedure of choice to avoid adverse effects seen with bilateral ablative procedures. The use of medication and/or surgery can provide adequate tremor control in the majority of the patients.

Keywords

Propranolol Clozapine Deep Brain Stimulation Botulinum Toxin Gabapentin 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

No sources of funding were used to assist in the preparation of this manuscript. The authors have reported the following conflicts of interest: Kelly Lyons — consultant Medtronic; Rajesh Pahwa — consultant Medtronic, speaker Medtronic, Novartis, investigator Ortho McNeil; Cynthia Comella — consultant Elan, Allergan, speaker Elan, Allergan, research grants Elan, Allergan; Joseph Jankovic — research grants Medtronic, Allergan; William Koller — consultant Medtronic, Elan, Novartis, speaker Novartis; William Ondo — speaker Allergan; investigator Ortho McNeil; Kapil Sethi — consultant Elan, Novartis, research grants Novartis, Elan, speaker Elan; Ray Watts — consultant and speaker Novartis.

References

  1. 1.
    Lou JS, Jankovic J. Essential tremor: clinical correlates in 350 patients. Neurology 1991; 41: 234–8PubMedGoogle Scholar
  2. 2.
    Louis ED, Ottman R, Hauser WA. How common is the most common adult movement disorder? estimates of the prevalence of essential tremor throughout the world. Mov Disord 1998; 13: 5–10PubMedGoogle Scholar
  3. 3.
    Elble RJ. Diagnostic criteria for essential tremor and differential diagnosis. Neurology 2000; 54: S2–6PubMedGoogle Scholar
  4. 4.
    Deuschl G, Bain P, Brin M. Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee. Mov Disord 1998; 13: 2–23PubMedGoogle Scholar
  5. 5.
    Findley LJ. Classification of tremors. J Clin Neurophysiol 1996; 13: 122–32PubMedGoogle Scholar
  6. 6.
    Marshall J. Tremor. In: Vinken PJ, Bruyn GW, editors. Handbook of clinical neurology. Vol 6. Amsterdam: North-Holland Publishing Co, 1968: 809–25Google Scholar
  7. 7.
    Winkler GF, Young RR. Efficacy of chronic propranolol therapy in action tremors of the familial, senile or essential varieties. N Engl J Med 1974; 290: 984–8PubMedGoogle Scholar
  8. 8.
    Sevitt I. The effect of adrenergic beta-receptor blocking drugs on tremor. Practitioner 1971; 207: 677–8PubMedGoogle Scholar
  9. 9.
    Winkler GF, Young RR. The control of essential tremor by propranolol. Trans Am Neurol Assoc 1971; 96: 66–8PubMedGoogle Scholar
  10. 10.
    Tolosa ES, Loewenson RB. Essential tremor: treatment with propranolol. Neurology 1975; 25: 1041–4PubMedGoogle Scholar
  11. 11.
    Murray TJ. Long-term therapy of essential tremor with propranol. Can Med Assoc J 1976; 115: 892–4PubMedGoogle Scholar
  12. 12.
    Dupont E, Hansen HJ, Dalby MA. Treatment of benign essential tremor with propranolol: a controlled clinical trial. Acta Neurol Scand 1973; 69: 75–84Google Scholar
  13. 13.
    Teräväinen H, Fogelholm R, Larsen A. Effect of propranolol on essential tremor. Neurology 1976; 26: 27–30PubMedGoogle Scholar
  14. 14.
    Sweet RD, Blumberg J, Lee JE, et al. Propranolol treatment of essential tremor. Neurology 1974; 24: 64–7PubMedGoogle Scholar
  15. 15.
    Calzetti S, Findley LJ, Gresty MA, et al. Effect of a single dose of propranolol on essential tremor: a double-blind controlled study. Ann Neurol 1983; 13: 165–71PubMedGoogle Scholar
  16. 16.
    Calzetti S, Findley LJ, Perucca E, et al. The response of essential tremor to propranolol: evaluation of clinical variables governing the efficacy of prolonged administration. J Neurol Neurosurg Psychiatry 1983; 46: 393–8PubMedGoogle Scholar
  17. 17.
    Koller WC. Dose-response relationship of propranolol in essential tremor. Arch Neurol 1986; 35: 42–3Google Scholar
  18. 18.
    Koller WC. Long-acting propranolol in essential tremor. Neurology 1985; 36: 108–10Google Scholar
  19. 19.
    Cleeves L, Findley L. Propranolol and propranolol-LA in essential tremor: a double-blind comparative study. J Neurol Neurosurg Psychiatry 1988; 51: 379–81PubMedGoogle Scholar
  20. 20.
    Physician’s Desk Reference. 57th Edition. Thompson PDR; Montvale (NJ), 2003Google Scholar
  21. 21.
    Young RR. Essential-familial tremor and other action tremors. Semin Neurol 1982; 2: 386–91Google Scholar
  22. 22.
    Koller WC, Royse V. Time course of a single oral dose of propranolol in essential tremor. Neurology 1985; 35: 1494–9PubMedGoogle Scholar
  23. 23.
    Jefferson D, Jenner P, Marsden CD. Beta-adrenoreceptor antagonists in essential tremor. J Neurol Neurosurg Psychiatry 1979; 42: 904–9PubMedGoogle Scholar
  24. 24.
    Huttunen J, Teräväinen H, Larsen A. Beta-adrenoreceptor antagonist in essential tremor [brief report]. Lancet 1984; II: 857Google Scholar
  25. 25.
    Britt CR, Peters BH. Metoprolol for essential tremor [brief report]. N Engl J Med 1979; 301: 331PubMedGoogle Scholar
  26. 26.
    Ljung O. Treatment of essential tremor with metoprolol [brief report]. N Engl J Med 1979; 301: 1005PubMedGoogle Scholar
  27. 27.
    Newman RP, Jacobs L. Metoprolol in essential tremor. Arch Neurol 1980; 37: 596–7PubMedGoogle Scholar
  28. 28.
    Riley T, Pleet AB. Metoprolol tartrate for essential tremor [brief report]. N Engl J Med 1979; 301: 663PubMedGoogle Scholar
  29. 29.
    Turnbull DM, Shaw DA. Metoprolol in essential tremor. Lancet 1980; I: 95Google Scholar
  30. 30.
    Calzetti S, Findley LJ, Gresty MA, et al. Metoprolol and propranolol in essential tremor: a double-blind controlled study. J Neurol Neurosurg Psychiatry 1981; 44: 814–9PubMedGoogle Scholar
  31. 31.
    Koller WC, Biary N. Metoprolol compared to propranolol in the treatment of essential tremor. Arch Neurol 1984; 41: 171–2PubMedGoogle Scholar
  32. 32.
    Koller WC. Nadolol in the treatment of essential tremor. Neurology 1983; 33: 1074–5PubMedGoogle Scholar
  33. 33.
    Dietrichson P, Espen E. Effects of timolol and atenolol on benign essential tremor: placebo-controlled studies based on quantitative tremor recordings. J Neurol Neurosurg Psychiatry 1981; 44: 677–83PubMedGoogle Scholar
  34. 34.
    Teräväinen H, Larsen A, Fogelheim R. Comparison between the effects of pindolol and propranolol on essential tremor. Neurology 1977; 27: 439–43PubMedGoogle Scholar
  35. 35.
    Koller WC, Larsen L, Potempa K. Pindolol-induced tremor. Clin Neuropharmacol 1987; 10: 449–60PubMedGoogle Scholar
  36. 36.
    Kuroda Y, Kakigi R, Shilasaki H. Treatment of essential tremor with arotinolol. Neurology 1988; 38: 650–1PubMedGoogle Scholar
  37. 37.
    O’Brien MD, Upton AR, Toseland PA. Benign familial tremor treated with primidone. BMJ 1981; 282: 178–80PubMedGoogle Scholar
  38. 38.
    Chakrabarti A, Pearce JMS: Essential tremor: response to primidone [brief report]. J Neurol Neurosurg Psychiatry 1981; 44: 650PubMedGoogle Scholar
  39. 39.
    Findley LJ, Cleeves L, Calzetti S. Primidone in essential tremor of the hands and head: a double-blind controlled clinical study. J Neurol Neurosurg Psychiatry 1985; 481: 911–5Google Scholar
  40. 40.
    Koller WC, Royse V. Efficacy of primidone in essential tremor. Neurology 1986; 36: 121–4PubMedGoogle Scholar
  41. 41.
    Calzetti S, Findley L, Risani F, et al. Phenyethylmalonamide in essential tremor. J Neurol Neurosurg Psychiatry 1981; 44: 932–4PubMedGoogle Scholar
  42. 42.
    Findley LJ, Calzetti S. Double-blind controlled study of primidone in essential tremor: preliminary results. BMJ 1982; 285: 608PubMedGoogle Scholar
  43. 43.
    Gorman WP, Cooper R, Pocock P, et al. A comparison of primidone, propranolol, and placebo in essential tremor using quantitative analysis. J Neurol Neurosurg Psychiatry 1986; 491: 64–8Google Scholar
  44. 44.
    Crystal HA. Duration of effectiveness of primidone in essential tremor. Neurology 1986; 36: 1543PubMedGoogle Scholar
  45. 45.
    Shale H, Fahn S. Response to essential tremor to treatment with primidone [abstract]. Neurology 1987; 37: 123Google Scholar
  46. 46.
    Sasso E, Perucca E, Fava N, et al. Primidone in the long-term treatment of essential tremor: a prospective study with computerized quantitative analysis. Clin Neuropharmacol 1990; 13: 67–76PubMedGoogle Scholar
  47. 47.
    Huber SJ, Paulson GW. Efficacy of alprazolam for essential tremor. Neurology 1988; 38(2): 241–3PubMedGoogle Scholar
  48. 48.
    Gunal DI, Afsar N, Bekiroglu N, et al. New alternative agents in essential tremor therapy; double-blind placebo-controlled study of alprazolam and acetazolamide. Neurol Sci 2000; 21: 315–7PubMedGoogle Scholar
  49. 49.
    Thompson C, Lang A, Parkes JD, et al. A double-blind trial of clonazepam in benign essential tremor. Clin Neuropharmacol 1984; 7: 83–8PubMedGoogle Scholar
  50. 50.
    Biary N, Koller W. Kinetic predominant essential tremor: successful treatment with clonazepam. Neurology 1987; 37: 471–4PubMedGoogle Scholar
  51. 51.
    Heilman KM. Orthostatic tremor. Arch Neurol 1984; 41: 880–1PubMedGoogle Scholar
  52. 52.
    McManis PG, Sharbrough FW. Orthostatic tremor: clinical and electrophysiologic characteristics. Muscle Nerve 1993; 16: 1254–60PubMedGoogle Scholar
  53. 53.
    Burrows GT, King RB. Gabapentin in essential tremor [abstract]. Neurology 1995; 45Suppl. 4: A187–I88Google Scholar
  54. 54.
    Adler CH. Effectiveness of gabapentin in various movement disorders [abstract]. Mov Disord 1996; 11Suppl. 1: 251Google Scholar
  55. 55.
    Merren MD. Gabapentin for treatment of pain and tremor: a large case series. South Med J 1998; 91: 739–44PubMedGoogle Scholar
  56. 56.
    Gironell A, Barbanoj M, Kulisevsky J, et al. A randomized placebo controlled comparative trial of gabapentin and propranolol in essential tremor. Arch Neurol 1999; 56(4): 475–80PubMedGoogle Scholar
  57. 57.
    Ondo WG, Hunter C, Schwartz K, et al. High dose gabapentin for essential tremor: a double-blind, placebo-controlled, crossover trial. Mov Disord 2000; 15: 678–82PubMedGoogle Scholar
  58. 58.
    Pahwa R, Lyons K, Hubble J, et al. Double-blind controlled trial of gabapentin in essential tremor. Mov Disord 1998; 13: 465–7PubMedGoogle Scholar
  59. 59.
    Gee NS, Brown JP, Dissanayake VUK, et al. The novel anticonvulsant drug, gabapentin (Neurontin), binds to the a2δ subunit of a calcium channel. J Biol Chem 1996; 271: 5768–76PubMedGoogle Scholar
  60. 60.
    Schumacher TB, Beck H, Steinhauser C, et al. Effects of phenytoin, carbamazepine, and gabapentin on calcium channels in hippocampal granule cells from patients with temporal lobe epilepsy. Epilepsia 1998; 39: 355–63PubMedGoogle Scholar
  61. 61.
    Kelly KM. Gabapentin. Neuropsychobiology 1998; 38: 139–44PubMedGoogle Scholar
  62. 62.
    Taylor CP, Gee NS, Su TZ, et al. A summary of mechanistic hypotheses of gabapentin pharmacology. Epilepsy Res 1998; 29: 233–49PubMedGoogle Scholar
  63. 63.
    Goa KL, Sorkin EM. Gabapentin. Drugs 1993; 46: 409–27PubMedGoogle Scholar
  64. 64.
    Connor GS. Topiramate as a novel treatment for essential tremor [abstract]. Mov Disord 1999; 14: 908Google Scholar
  65. 65.
    Connor GS. A randomized double-blind placebo controlled trial of topiramate treatment for essential tremor. Neurology 2002; 59: 132–4PubMedGoogle Scholar
  66. 66.
    Glauser TA. Topiramate. Epilepsia 1999; 40Suppl. 5: S71–80PubMedGoogle Scholar
  67. 67.
    Kawasaki H, Tancredi V, D’Arcangelo G, et al. Multiple actions of the novel anticonvulsant drug topiramate in the rat subiculum in vitro. Brain Res 1998; 807: 125–34PubMedGoogle Scholar
  68. 68.
    Petroff OA, Hyder F, Mattson RH, et al. Topiramate increases brain GABA, homocarnosine, and pyrrolidinone in patients with epilepsy. Neurology 1999; 52: 473–8PubMedGoogle Scholar
  69. 69.
    Montecucco C, Shiavo G, Rossetto O. The mechanism of action of tetanus and botulinum neurotoxins. Arch Toxicol Suppl 1996; 18: 342–54PubMedGoogle Scholar
  70. 70.
    Catsicas S, Grenningloh G, Pcij EM. Nerve-terminal proteins: to fuse to learn. Trends Neurosci 1994; 17: 368–73PubMedGoogle Scholar
  71. 71.
    Jost WH, Kohl A. Botulinum toxin: evidence-based medicine criteria in rare conditions. J Neurol 2000; 248Suppl. 1: I39–44Google Scholar
  72. 72.
    Jankovic J, Schwartz K. Botulinum toxin treatment of tremors. Neurology 1991; 41: 1185–8PubMedGoogle Scholar
  73. 73.
    Jankovic J, Schwartz K, Clemence W, et al. A randomized, double-blind, placebo-controlled study to evaluate botulinum toxin type A in essential hand tremor. Mov Disord 1996; 11: 250–6PubMedGoogle Scholar
  74. 74.
    Brin MF, Lyons KE, Doucette J, et al. A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor. Neurology 2001; 56: 1523–8PubMedGoogle Scholar
  75. 75.
    Pacchetti C, Mancini F, Bulgheroni M, et al. Botulinum toxin treatment for functional disability induced by essential tremor. Neurol Sci 2000; 21: 349–53PubMedGoogle Scholar
  76. 76.
    Trosch RM, Pullman SL. Botulinum toxin A injections for the treatment of hand tremors. Movement Dis 1994; 9: 601–9PubMedGoogle Scholar
  77. 77.
    Henderson JM, Ghika JA, Van Melle G, et al. Botulinum toxin A in non-dystonic tremors. Eur Neurol 1996; 36: 29–35PubMedGoogle Scholar
  78. 78.
    Wissel J, Masuhr F, Schelosky L, et al. Quantitative assessment of botulinum toxin treatment in 43 patients with head tremor. Mov Disord 1997; 12: 722–6PubMedGoogle Scholar
  79. 79.
    Pahwa R, Busenbark K, Swanson-Hyland EF, et al. Botulinum toxin treatment of essential head tremor. Neurology 1995; 45: 822–4PubMedGoogle Scholar
  80. 80.
    Blitzer A, Brin MF, Stewart C, et al. Abductor laryngeal dystonia: a series treated with botulinum toxin. Laryngoscope 1992; 102: 163–7PubMedGoogle Scholar
  81. 81.
    Hertegard S, Granqvist S, Lindestad PA. Botulinum toxin injections for essential voice tremor. Ann Otol Rhinol Laryngol 2000; 109: 204–9PubMedGoogle Scholar
  82. 82.
    Warrick P. The treatment of essential voice tremor with botulinum toxin A: a longitudinal case report. J Voice 2000; 14: 410–21PubMedGoogle Scholar
  83. 83.
    Warrick P. Botulinum toxin for essential tremor of the voice with multiple anatomical sites of tremor: a crossover design study of unilateral versus unilateral injection. Laryngoscope 2000; 110: 1266–374Google Scholar
  84. 84.
    Cho JW, Chu K, Jeon BS. Case of essential palatal tremor: atypical features and remarkable benefit from botulinum toxin injection. Mov Disord 2001; 16: 779–82PubMedGoogle Scholar
  85. 85.
    Bakar M, Zarifoglu M, Bora I, et al. Treatment of trembling chin with botulinum toxin. Mov Disord 1998; 13: 845–6PubMedGoogle Scholar
  86. 86.
    Koller WC, Hristova A, Brin M. Pharmacologic treatment of essential tremor. Neurology 2000; 54Suppl. 4: S30–8PubMedGoogle Scholar
  87. 87.
    Muenter MD, Daube JR, Caviness JN, et al. Treatment of essential tremor with methazolamide. Mayo Clinic Proc 1991; 66: 991–7Google Scholar
  88. 88.
    Busenbark K, Pahwa R, Hubble J, et al. The effect of acetazolamide on essential tremor: an open-label trial. Neurology 1992; 42: 1394–13495PubMedGoogle Scholar
  89. 89.
    Busenbark K, Pahwa R, Hubble J, et al. Double-blind controlled study of methazolamide in the treatment of essential tremor. Neurology 1993; 43: 104–1047Google Scholar
  90. 90.
    Baruzzi A, Procaceranti G, Martinelle P. Phenobarbital and propranolol in essential tremor: a double-blind controlled clinical trial. Neurology 1983; 33: 296–300PubMedGoogle Scholar
  91. 91.
    Findley LJ, Cleeves L. Phenobarbital in essential tremor. Neurology 1985; 35: 1784–7PubMedGoogle Scholar
  92. 92.
    Sasso E, Perucca E, Calzetti S. Double-blind comparison of primidone and phenobarbital in essential tremor. Neurology 1988; 38: 808–10PubMedGoogle Scholar
  93. 93.
    Topaktas S, Onur R, Dalkara T. Calcium channel blockers and essential tremor. Eur Neurol 1987; 27: 114–9PubMedGoogle Scholar
  94. 94.
    Garcia-Ruiz PJ, Garcia de Yenebes Prous J, Jimenez-Jimenez J. Effect of nicardipine on essential tremor: brief report. Clin Neuropharmacol 1993; 16: 456–9PubMedGoogle Scholar
  95. 95.
    Jimenez-Jimenez FJ, Garcia-Ruiz PJ, Cabrera-Valdivia F. Nicardipine versus propranolol in essential tremor. Acta Neurol (Napoli) 1994; 16(4): 184–8Google Scholar
  96. 96.
    Biary N, Bahou Y, Sofi MA, et al. The effect of nimodipine on essential tremor. Neurology 1995; 45: 1523–5PubMedGoogle Scholar
  97. 97.
    Hallett M, Ravits J, Dubinsky RM, et al. A double-blind trial of isoniazid for essential tremor and other action tremors. Mov Disord 1991; 6(3): 253–6PubMedGoogle Scholar
  98. 98.
    Caccia MR, Mangoni A. Clonidine in essential tremor: preliminary observations from an open trial. J Neurol 1985; 232: 55–7PubMedGoogle Scholar
  99. 99.
    Koller WC, Herbster G, Cone S. Clonidine in the treatment of essential tremor. Mov Disord 1986; 1: 235–7PubMedGoogle Scholar
  100. 100.
    Caccia MR, Osio M, Galimberti V, et al. Propranolol, clonidine, urapidil and trazodone infusion in essential tremor: a double-blind crossover trial. Acta Neurol Scand 1989; 79(5): 379–83PubMedGoogle Scholar
  101. 101.
    Pakkenberg H, Pakkenberg B. Clozapine in the treatment of tremor. Acta Neurol Scand 1986; 73: 295–7PubMedGoogle Scholar
  102. 102.
    Ceravolo R, Salvetti S, Piccini P, et al. Acute and chronic effects of clozapine in essential tremor. Mov Disord 1999; 14(3): 468–72PubMedGoogle Scholar
  103. 103.
    Pact V, Giduz T. Mirtazapine treats resting tremor, essential tremor, and levodopa induced dyskinesias [clinical/scientific note]. Neurology 1999; 53: 1154PubMedGoogle Scholar
  104. 104.
    Ertan S, Koksal A, Ozekmekci S. Clinical efficacy of mirtazapine in essential tremor [abstract P557]. Mov Disord 2000; 15(S3): 102Google Scholar
  105. 105.
    Lyons KE, Pahwa R. A double-blind, placebo-controlled, pilot study of mirtazapine in essential tremor [abstract]. Neurology 2002; 58Suppl. 3: A254Google Scholar
  106. 106.
    Laitinen L. Stereotaxic treatment of hereditary tremor. Acta Neurol Scand 1965; 41: 74–9PubMedGoogle Scholar
  107. 107.
    Blacker HM, Bertrand C, Martinez N, et al. Hypotonia accompanying the neurosurgical relief of essential tremor. J Nerv Ment Dis 1968; 147: 49–55PubMedGoogle Scholar
  108. 108.
    Bertrand C, Hardy J, Molina-Negro P, et al. Tremor of attitude. Confin Neurol 1969; 31: 37–41PubMedGoogle Scholar
  109. 109.
    van Manen J. Stereotaxic operations in cases of hereditary and intention tremor. Acta Neurochir (Wien) 1974; Suppl. 21: 49–55Google Scholar
  110. 110.
    Ohye C, Hirai T, Miyazaki M, et al. Vim thalamotomy for the treatment of various kinds of tremor. Appl Neurophysiol 1982; 45: 275–80PubMedGoogle Scholar
  111. 111.
    Nagaseki Y, Shibazaki T, Hirai T, et al. Long-term follow-up results of selective VIM-thalamotomy. J Neurosurg 1986; 65: 296–302PubMedGoogle Scholar
  112. 112.
    Mohadjer M, Goerke H, Milios E, et al. Long-term results of stereotaxy in the treatment of essential tremor. Stereotact Funct Neurosurg 1990; 55: 125–9Google Scholar
  113. 113.
    Goldman MS, Kelly PJ. Symptomatic and functional outcome of stereotactic ventralis lateralis thalamotomy for intention tremor. J Neurosurg 1992; 77: 223–9PubMedGoogle Scholar
  114. 114.
    Jankovic J, Cardoso F, Grossman RG, et al. Outcome after stereotactic thalamotomy for parkinsonian, essential, and other types of tremor. Neurosurgery 1995; 37: 680–6PubMedGoogle Scholar
  115. 115.
    Tasker RR. Movement disorders. In: Apuzzo MLJ, editor. Brain surgery complication avoidance and management. New York: Churchill Livingstone, 1993: 1509Google Scholar
  116. 116.
    Activa tremor control therapy reference guide. Minneapolis: Medtronics, 1997Google Scholar
  117. 117.
    Benabid AL, Pollak P, Gervason C, et al. Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 1991; 337: 403–6PubMedGoogle Scholar
  118. 118.
    Blond S, Caparros-Lefebvre D, Parker F, et al. Control of tremor and involuntary movement disorders by chronic stereotactic stimulation of the ventral intermediate thalamic nucleus. J Neurosurg 1992; 77: 62–8PubMedGoogle Scholar
  119. 119.
    Benabid AL, Pollak P, Seigneuret E, et al. Chronic VIM thalamic stimulation in Parkinson’s disease, essential tremor and extra-pyramidal dyskinesias. Acta Neurochir Suppl (Wien) 1993; 58: 39–44Google Scholar
  120. 120.
    Alesch F, Pinter MM, Helscher RJ, et al. Stimulation of the ventral intermediate thalamic nucleus in tremor dominated Parkinson’s disease and essential tremor. Acta Neurochir (Wien) 1995; 136: 75–81Google Scholar
  121. 121.
    Benabid AL, Pollak P, Gao D, et al. Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders. J Neurosurg 1996; 84: 203–14PubMedGoogle Scholar
  122. 122.
    Hubble JP, Busenbark KL, Wilkinson S, et al. Deep brain stimulation for essential tremor. Neurology 1996; 46: 1150–3PubMedGoogle Scholar
  123. 123.
    Koller W, Pahwa R, Busenbark K, et al. High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor. Ann Neurol 1997; 42: 292–9PubMedGoogle Scholar
  124. 124.
    Ondo W, Jankovic J, Schwartz K, et al. Unilateral thalamic deep brain stimulation for refractory essential tremor and Parkinson’s disease tremor. Neurology 1998; 51: 1063–9PubMedGoogle Scholar
  125. 125.
    Koller WC, Lyons KE, Wilkinson SB, et al. Long-term safety and efficacy of unilateral deep brain stimulation of the thalamus in essential tremor. Mov Disord 2001; 16: 464–8PubMedGoogle Scholar
  126. 126.
    Pahwa R, Lyons KE, Wilkinson SB, et al. Bilateral thalamic stimulation for essential tremor. Neurology 1998; 50Suppl. 4: A19Google Scholar
  127. 127.
    Carpenter MA, Pahwa R, Miyawaki KL, et al. Reduction in voice tremor under thalamic stimulation. Neurology 1998; 50: 796–8PubMedGoogle Scholar
  128. 128.
    Koller WC, Lyons KE, Wilkinson SB, et al. Efficacy of unilateral deep brain stimulation of the VIM nucleus of the thalamus for essential head tremor. Mov Disord 1999; 14: 847–50PubMedGoogle Scholar
  129. 129.
    Obwegeser AA, Uitti RJ, Turk MF, et al. Thalamic stimulation for the treatment of midline tremors in essential tremor patients. Neurology 2000; 54: 2342–4PubMedGoogle Scholar
  130. 130.
    Tasker RR. Deep brain stimulation is preferable to thalamotomy for tremor suppression. Surg Neurol 1998; 49: 145–53PubMedGoogle Scholar
  131. 131.
    Schuurman PR, Bosch DA, Bossuyt PM, et al. A comparison of continuous thalamic stimulation and thalamotomy for suppression of severe tremor. N Engl J Med 2000; 342: 461–8PubMedGoogle Scholar
  132. 132.
    Pahwa R, Lyons KE, Wilkinson SB, et al. Comparison of thalamotomy to deep brain stimulation of the thalamus in essential tremor. Mov Disord 2001; 16: 140–3PubMedGoogle Scholar
  133. 133.
    Young RF, Jacques S, Mark R, et al. Gamma knife thalamotomy for treatment of tremor: long-term results. J Neurosurg 2000; 93Suppl. 3: 128–35PubMedGoogle Scholar
  134. 134.
    Niranjan A, Kondziolka D, Baser S, et al. Functional outcomes after gamma knife thalamotomy for essential tremor and MS-related tremor. Neurology 2000; 55: 443–6PubMedGoogle Scholar
  135. 135.
    Siderowf A, Gollump SM, Stern MB, et al. Emergence of complex involuntary movements after gamma knife radiosurgery for essential tremor. Mov Disord 2001; 16: 965–7PubMedGoogle Scholar
  136. 136.
    Deuschl G, Koster B, Lucking CH, et al. Diagnostic and pathophysiological aspects of psychogenic tremors. Mov Disord 1998; 13: 294–302PubMedGoogle Scholar
  137. 137.
    Lundervold DA, Belwood MF, Craney JL, et al. Reduction of tremor severity and disability following behavioral relaxation training. J Behav Ther & Exp Psychiat 1999; 30: 119–35Google Scholar
  138. 138.
    Bilodeau M, Keen DA, Sweeney PJ, et al. Strength training can improve steadiness in persons with essential tremor. Muscle Nerve 2000; 23: 771–8PubMedGoogle Scholar
  139. 139.
    Lundervold DA, Poppen R. Biobehavioral rehabilitation for older adults with essential tremor. Gerontologist 1995; 35: 556–9PubMedGoogle Scholar
  140. 140.
    Chung W, Poppen R, Lundervold DA. Behavioral relaxation training for tremor disorders in older adults. Biofeedback Self Regul 1995; 20: 123–35PubMedGoogle Scholar

Copyright information

© Adis Data Information BV 2003

Authors and Affiliations

  • Kelly E. Lyons
    • 1
  • Rajesh Pahwa
    • 1
    Email author
  • Cynthia L. Comella
    • 2
  • Mahmood S. Eisa
    • 3
  • Rodger J. Elble
    • 4
  • Stanley Fahn
    • 5
  • Joseph Jankovic
    • 6
  • Jorge L. Juncos
    • 7
  • William C. Koller
    • 8
  • William G. Ondo
    • 6
  • Kapil D. Sethi
    • 9
  • Matthew B. Stern
    • 3
  • Caroline M. Tanner
    • 10
  • Ron Tintner
    • 6
  • Ray L. Watts
    • 7
  1. 1.Department of NeurologyUniversity of Kansas Medical CenterKansas CityUSA
  2. 2.Rush Presbyterian St. Luke’s Medical CenterChicagoUSA
  3. 3.Pennsylvania HospitalPhiladelphiaUSA
  4. 4.Southern Illinois University School of MedicineSpringfieldUSA
  5. 5.Columbia UniversityNew YorkUSA
  6. 6.Baylor College of MedicineHoustonUSA
  7. 7.Emory UniversityAtlantaUSA
  8. 8.Mt. Sinai Medical CenterNew YorkUSA
  9. 9.Medical College of GeorgiaAugustaUSA
  10. 10.The Parkinson InstituteSunnyvaleUSA

Personalised recommendations