Essential tremor
- Treat only if tremor impairs function
- Propranolol or primidone are first-line
- Choose by BP, asthma, sedation + comorbidity
- Topiramate can help selected patients
- Botulinum toxin for focal/head/voice tremor
- Refractory severe tremor → DBS/focused ultrasound
- Alcohol response is diagnostic—not a therapy
Use at a glance
- Treat only if tremor impairs function
Treatment options
- Propranolol or primidone are first-line
Other treatment options
- Alcohol response is diagnostic—not a therapy
Escalation / refractory disease
- Choose by BP, asthma, sedation + comorbidity
- Topiramate can help selected patients
- Refractory severe tremor → DBS/focused ultrasound
Practical pearls
- Botulinum toxin for focal/head/voice tremor
Self-check
- Which medications are first-line for essential tremor?
Propranolol or primidone.
Drugs used for this (2)
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