Tips and tricks in tremor treatment

Area of Science:

• Neurology
• Pharmacology
• Biomedical Engineering

Background:

• Tremor significantly impacts patient quality of life, necessitating effective treatment algorithms.
• Diverse etiologies of tremor, including neurological diseases, other conditions, and medication side effects, present complex management challenges.

Purpose of the Study:

• To review current treatment strategies for various tremor types.
• To highlight the importance of personalized management approaches considering patient needs and tolerability.

Main Methods:

• Review of pharmacological treatments: Levodopa, dopamine agonists, propranolol, primidone, anticholinergics, clozapine, 1-Octanol, and anticonvulsants.
• Exploration of advanced therapies: Deep brain stimulation and focused ultrasound for resistant cases.
• Inclusion of non-drug interventions: Sensor-based detection, wristbands, and physical therapy.

Main Results:

• Levodopa is key for Parkinson's tremor, with variable response.
• Propranolol is effective for essential tremor (ET/ET+), sometimes combined with primidone.
• Reserve medications and advanced therapies address specific or resistant tremor types.
• Medication review is critical, especially for drug-induced tremors.

Conclusions:

• Optimal tremor management requires integrating pharmacological, non-invasive, and technological approaches.
• Tailored strategies considering patient-specific factors are essential for symptom control and improved quality of life.
• Emerging sensor-based and non-drug interventions offer promising future enhancements in tremor care.