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MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
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Orthostatic Tremor: Pathophysiology Guiding Treatment
David Whitney1, Danish Bhatti1, Diego Torres-Russotto2
1Movement Disorders Section, Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
Current Treatment Options in Neurology
|July 23, 2018
Summary
Orthostatic tremor (OT) is a rare neurological disorder. Recent research clarifies its brain network and identifies clonazepam, gabapentin, and deep brain stimulation as potential treatments, though efficacy varies.
Area of Science:
- Neurology
- Neuroscience
- Movement Disorders
Background:
- Orthostatic tremor (OT) is a rare condition causing unsteadiness and tremor when standing.
- Its pathophysiology is not fully understood, and treatment options are limited.
Purpose of the Study:
- To review recent advancements in understanding the pathophysiology of orthostatic tremor.
- To summarize current and emerging treatment strategies for orthostatic tremor.
Main Methods:
- Review of recent functional neuroimaging studies (fMRI, 18F-FDG-PET).
- Analysis of case reports and small series on treatment efficacy.
- Evaluation of deep brain stimulation outcomes for refractory cases.
Main Results:
- Identified a ponto-cerebello-thalamo-cortical network implicated in OT pathophysiology.
- Clonazepam and gabapentin show promise as medical therapies.
- Deep brain stimulation in the ventral intermediate nucleus is a potential option for severe cases.
Conclusions:
- Understanding of OT pathophysiology has improved, but remains incomplete.
- Current treatments offer modest and inconsistent benefits.
- Further research may uncover novel therapeutic targets for orthostatic tremor.
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