What is the treatment for tremors?
There is no cure for tremor and, in most cases, there is no need to treat essential tremor. Treatment may not be required if the tremors are mild and do not interfere with daily activity. However, severe tremor can be reduced with drug treatment. A drug called propranolol is often used to treat severe essential tremor. However, this drug can have side effects that affect the heart, so its use must be monitored carefully. Other drugs used to treat essential tremor include primidone and
benzodiazepine. People with Parkinson's disease have had success with levodopa or other antiparkinson drugs. Botulinum toxin A has been found effective in treating head, hand, and voice tremors. Botulinum is a bacterium that causes food poisoning (botulism), but causes the muscles to relax when used in a weak solution. Discuss all the possible side effects of botulinum toxin A with your doctor before trying this treatment.
Another technique for controlling severe tremor involves using mild electrical pulses to stimulate the brain. A surgeon implants an electrode in the area of the brain where nerve impulses are relayed and movement is generated. A wire from the electrode follows a path under the skin from the skull to a small generator implanted in the chest. The patient turns on the generator with a hand-held magnet to deliver an electronic pulse to the brain, which blocks the brain signals that trigger tremor. This treatment is not effective for everyone, so it is important to discuss this option thoroughly with your doctor.
Other surgical procedures for patients with severe tremor include thalamotomy, in which the surgeon destroys part of the thalamus; and pallidotomy, in which the surgeon destroys part of a small structure within the brain called the globus pallidus internus. Pallidotomy is sometimes used to treat tremors from Parkinson's disease. Both of these surgical techniques destroy portions of the brain that affect movement, and may have negative side effects concerning balance and coordination. Stem cell transplantation, in which fetal tissue is implanted in a patient's brain to replace malfunctioning nerves, is an ongoing source of controversial research but has shown some promise in treating conditions such as Parkinson's disease.
The success of medications to treat tremor varies. It depends on individual response. Medications that may reduce tremors include propranolol, Mysoline and other anticonvulsants, and mild tranquilizers. Caffeine (in substances such as coffee and soda) and other stimulants should be avoided because they commonly worsen tremors. |