What is the most effective treatment for essential tremor?

Mild tremor does not necesitize**;

Patients with mild to moderate disease may choose to take the medication half an hour earlier to reduce symptoms intermittently due to work or social needs;

Moderate to severe tremor that interferes with daily life and work, requiring medication**;

Surgery may be considered in patients with severe disease refractory to medication**;

Botulinum toxin type A injections are an option for patients with head or voice tremors**.

Drugs**. Due to individual differences, there is no absolute best, fastest and most effective medication, except for commonly used over-the-counter drugs, the most appropriate drug should be selected under the guidance of a doctor in full combination with individual circumstances.

First-line recommended medications.

Propranolol. Propranolol is a non-selective receptor blocker and is the classic first-line drug.

Efficacy: It can effectively reduce the amplitude of limb tremor by 50% (the frequency of tremor does not decrease), but the effect on axial tremor (such as head, voice, etc.) is not good.

Adverse reactions: Decreased heart rate and blood pressure are common, but patients with a heart rate of 60 beats can tolerate it. During the medication, the changes in heart rate and blood pressure should be closely observed, such as the heart rate can be reduced when the heart rate is 60 beats, and the drug should be stopped when the heart rate is 55 beats; The use of the drug is prohibited in patients with unstable cardiac insufficiency, severe, and insulin-dependent diabetes mellitus; Other uncommon side effects include fatigue, nausea, diarrhea, rash, impotence, and depression.

Primidone. Primidone is a commonly used antiepileptic drug.

Efficacy: It is effective for hand tremor, reducing tremor amplitude by 50%.

Adverse reactions: In the early stage of medication, the incidence of acute reactions (including dizziness, nausea, vomiting, unsteady walking, drowsiness, acute toxic reactions, etc.) is relatively high, and most of the adverse reactions will gradually decrease or reach tolerance after a few days.

Alolol. Efficacy: It can reduce the amplitude of postural tremor and action tremor, and the effect is similar to propranolol.

Alolol has 4-5 times more receptor blocking activity than propranolol, and does not easily cross the blood-brain barrier and does not produce the central nervous system like propranolol***. Therefore, it may be considered in patients who cannot tolerate propranolol**.

Adverse reactions: , vertigo, etc. Heart rate and blood pressure changes should be closely observed during the medication, and if the heart rate is 60 beats or there is significant hypotension, the dose should be reduced or stopped.

Second-line recommended medications.

The main ones are gabapentin, topiramate, atenolol, sotalol, etc.

Third-line recommended medication.

The main ones are nadolol、、、 botulinum toxin type A, etc.

Botulinum toxin type A has more advantages in head and voice tremors, and can also be used for limb tremors.

A single dose (40 400 IU) of botulinum toxin type A given intramuscularly reduces tremor amplitude in the upper extremities.

The most common adverse effects are finger weakness and limb stiffness.

Botulinum toxin type A injected with IU in the soft palate may cause voice tremor, but hoarseness and dysphagia may occur***.

Botulinum toxin type A**Refractory tremor is symptomatic**, usually with a single injection lasting 3 to 6 months, and repeated injections are required to maintain efficacy.

Essential tremor refers to limb tremor in exceptional circumstances. Such as shaking hands and shaking heads. Essential tremor is divided into early, middle and late stages.

Early symptoms occur occasionally, and subconscious exercise is sufficient, without the need for **. In the middle stage, it is recommended that a certain amount of medication can be taken to reduce the condition of the disease, and in the later stage, surgery can be considered**. If it is a tremor with a head or difficulty, the patient can go to the hospital for examination, and target ** according to the symptoms.

Because essential tremor** and its pathogenesis have not been fully elucidated, there is still a lack of ****. Therefore, the current method is mainly symptomatic, with the goal of well controlling the tremor symptoms of essential tremor and improving the patient's psychological state and life function.

**Cycle. Essential tremor is not currently available** and is a lifelong condition that requires lifelong intermittent**.

Essential tremor.

The ** methods are: first.

1. Drugs**, such as chloropindiazepam, beta blockers, gabapentin, botulinum toxin A; Clause.

2. Surgery**, such as deep EEG stimulation and stereotactic thalamic destruction. Specifically, it is recommended to go to the hospital to find a doctor for help.

Essential tremor is an autosomal dominant disorder and is the most common extrapyramidal disorder. The disease is mainly treated with drugs**. A small number of patients with severe symptoms, predominantly one-sided symptoms, and ineffective medications** may be able to undergo surgery**.