Aktuelle Neurologie 2011; 38(06): 315-319
DOI: 10.1055/s-0031-1284408
Aktuelle Therapie
© Georg Thieme Verlag KG Stuttgart · New York

Aktuelle Therapie des Tremors

Current Therapy for Tremor
J. Raethjen
1   Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
› Author Affiliations
Further Information

Publication History

Publication Date:
12 September 2011 (online)

Zusammenfassung

Tremor ist eines der häufigsten neurologischen Symptome, und ist oft behandlungsbedürftig. Es stehen eine Reihe von Medikamenten zur Verfügung, die je nach klinischer Erscheinungsform des Tremors gezielt eingesetzt werden können. Mittlerweile gut etabliert ist die operative stereotaktische Behandlung mittels tiefer Hirnstimulation, die bei fast allen pathologischen Tremorformen deutlich wirksamer ist als die Medikamente. Die Therapieoptionen und die Eskalationsstufen für die häufigsten primär neurologischen Tremorer werden dargestellt.

Abstract

Tremor is one of the most common symptoms in clinical neurology and often needs treatment. Numerous drugs have antitremor effects and should be chosen according to the clinical appearance of the tremor syndrome. Deep brain stimulation after stereotactic electrode placement has meanwhile become a well established therapeutic option the effects of which are by far stronger than those of medical treatment in almost all pathological tremors. The therapeutic options and practical steps in the treatment of most primary neurological tremors are delineated.

 
  • Literatur

  • 1 Morgan JC, Sethi KD. Drug-induced tremors. Lancet Neurol 2005; 4: 866-876
  • 2 Bain P, Brin M, Deuschl G et al. Criteria for the diagnosis of essential tremor. Neurology 2000; 54 (Suppl. 04) S7
  • 3 Deuschl G, Bain P, Brin M. Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee. Mov Disord 1998; 13 (Suppl. 03) 2-23
  • 4 Koller WC. Long-acting propranolol in essential tremor. Neurology 1985; 35: 108-110
  • 5 O’Suilleabhain P, Dewey Jr RB. Randomized trial comparing primidone initiation schedules for treating essential tremor. Mov Disord 2002; 17: 382-386
  • 6 Zesiewicz TA. Low-dose topiramate (topamax) in the treatment of essential tremor. Clin Neuropharmacol 2007; 30: 247-248
  • 7 Gironell A, Kulisevsky J, Barbanoj M et al. A randomized placebo-controlled comparative trial of gabapentin and propranolol in essential tremor. Arch Neurol 1999; 56: 475-480
  • 8 Ondo W, Hunter C, Vuong KD et al. Gabapentin for essential tremor: a multiple-dose, double-blind, placebo-controlled trial. Mov Disord 2000; 15: 678-682
  • 9 Pahwa R, Lyons K, Hubble JP et al. Double-blind controlled trial of gabapentin in essential tremor. Mov Disord 1998; 13: 465-467
  • 10 Elble RJ, Pullman SL, Matsumoto JY et al. Tremor amplitude is logarithmically related to 4- and 5-point tremor rating scales. Brain 2006; 129: 2660-2666
  • 11 Deuschl G, Raethjen J, Hellriegel H et al. Treatment of patients with essential tremor. Lancet Neurol 2011; 10: 148-161
  • 12 Rehncrona S, Johnels B, Widner H et al. Long-term efficacy of thalamic deep brain stimulation for tremor: double-blind assessments. Mov Disord 2003; 18: 163-170
  • 13 Raethjen J, Govindan RB, Kopper F et al. Cortical involvement in the generation of essential tremor. J Neurophysiol 2007; 97: 3219-3228
  • 14 Schnitzler A, Munks C, Butz M et al. Synchronized brain network associated with essential tremor as revealed by magnetoencephalography. Mov Disord 2009; 24: 1629-1635
  • 15 Ehrt U, Broich K, Larsen JP et al. Use of drugs with anticholinergic effect and impact on cognition in Parkinson′s disease: a cohort study. J Neurol Neurosurg Psychiatry 2010; 81: 160-165
  • 16 Raethjen J, Pohle S, Govindan RB et al. Parkinsonian action tremor: interference with object manipulation and lacking levodopa response. Exp Neurol 2005; 194: 151-160
  • 17 Papapetropoulos S, Singer C. Treatment of primary writing tremor with botulinum toxin type a injections: report of a case series. Clin Neuropharmacol 2006; 29: 364-367
  • 18 Rodrigues JP, Edwards DJ, Walters SE et al. Blinded placebo crossover study of gabapentin in primary orthostatic tremor. Mov Disord 2006; 21: 900-905
  • 19 Espay AJ, Duker AP, Chen R et al. Deep brain stimulation of the ventral intermediate nucleus of the thalamus in medically refractory orthostatic tremor: preliminary observations. Mov Disord 2008; 23: 2357-2362
  • 20 Krauss JK, Weigel R, Blahak C et al. Chronic spinal cord stimulation in medically intractable orthostatic tremor. J Neurol Neurosurg Psychiatry 2006; 77: 1013-1016