Essential Tremor

Approaches to Treatment

For some patients with mild symptoms, no treatment may be required. Treatment options include:

• physical and psychological measures
• lifestyle changes
• pharmacologic treatments
• botulinum toxin injections
• surgery

The selection of treatment options must be based on individual needs, taking into account patient history, tremor severity, coexistent disease, current medications, response to previous therapy, and other factors.

The initiation of specific pharmacologic therapies is based on an evaluation of any prior exposure to medications, contraindications, and the benefits and potential side effects associated with particular agents. Selected patients with medication-resistant ET may benefit from chemodenervation with localized injections of botulinum toxin (BTX). In addition, for patients with severe, disabling ET, medication-refractory tremor, or adverse effects to pharmacologic treatment, surgery may be considered. In such cases, physicians and patients must work together to evaluate the possible risks versus the potential benefits of surgical management. The goal of any treatment plan for ET is to provide clinical benefit while minimizing potential side effects, thereby improving self-assessed functional ability, facilitating ADLs, and enhancing overall QOL.