Essential Tremor

Question 1

Essential tremor occurs at ______. The tremor is greatest in____ , but can affect _____as well.

Answer 1

both rest and with intention (reaching for things)

the hands
the head

Question 2

The examination is otherwise

Answer 2

normal.

Question 3

The tremor may affect some______ such as ____or the use of a ____. _____ makes it worse.

Answer 3

manual skills
handwriting
computer keyboard
Caffeine

Question 4

The best therapy for essential tremor is ____

Answer 4

propranolol.

Question 5

If the tremor persists despite beta blockers, add ____,which is an_____

Answer 5

primidone,

antiepileptic medication that controls tremor.

Question 6

If the tremor still persists, after primidone,________

Answer 6

switch treatment to topiramate or gabapentin.

Question 7

If tremor remains severe despite medical Tx, next step in management is

Answer 7

thalamotomy.

Question 8

how does thalamotomy. work?

Answer 8

This procedure ablates the thalamus with magnetic resonance focused ultrasound or unilateral thalamotomy by delivering local heat, and it definitely improves tremor severity.

Question 9

Tremor at rest and exertion improved with_____ is the key to the diagnosis.

Answer 9

a drink of alcohol