Essential Tremor Update (AAN 2004)

Subject: Essential Tremor Update (AAN 2004)

Date: 5/13/2004

Topiramate for Essential Tremor (AAN 2004)
E-MOVE reports from the American Academy of Neurology, San Francisco April 25-30, 2004. Page (A), session (S) and poster (P) numbers are from Neurology 2004;62(7), Suppl 5

Topiramate in essential tremor: A multicenter, double-blind, placebo-controlled trial
WG Ondo, J Jankovic, MA Stacy, RJ Elble, R Pahwa, GS Connor, JF Hulihan, L Schwarzman, SC Wu
LBS.004

Topiramate is effective for essential tremor, according to this study.

Two hundred and eight patients with ET (of whom 50% were not receiving other ET treatments) were randomized to receive placebo or topiramate titrated up to a maximum of 400 mg/day over 12 weeks, followed by a 12-week maintenance phase. Mean dose was 292 mg/day. The total normalized Tremor Rating Scale score improved 29% from baseline for topiramate, versus 16% for placebo (p<0.001). Significant differences were observed for specific motor tasks/function and functional disabilities subscores, , as well as both patient and investigator global assessments. One third of topiramate-treated patients discontinued due to adverse effects, versus 10% of placebo-treated patients. The most common adverse effects were paresthesias, weight loss, bad taste, fatigue, memory difficulty, nausea, decreased appetite, and sleepiness.

Depression and quality of life in essential tremor
R Pahwa, K Lyons
P06.117, A502

Ninety consecutive patients with essential tremor were assessed with the Beck Depression Inventory, Tremor Rating Scale, and PDQ-39 quality of life scale. Tremor rating score was significantly correlated with BDI and with PDQ-39 total score, as well as several subscores (mobility, ADLs, emotional well-being, and communication). Thirty-six patients had undergone DBS surgery. Despite more advanced age and longer disease duration, these patients had significantly less depression and improved quality of life compared to patients who had not undergone surgery.
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Essential tremor in children
J Madisetty, KD Vuong, J Jankovic
P06.118, A502

Clinical information from 30 patients with childhood-onset essential tremor indicated that 73% were male, mean onset was 9 years of age, and family history was positive in 77%. More than half had another neurological comorbidity, including dystonia (30%). Five of five patients treated with propanolol improved.
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E-MOVE Editor: Richard Robinson, NASW, WE MOVE

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