Essential Tremor/PGS/Diagnosis

Essential tremor, idiopathic, sometimes familial, is the most common cause of tremor (shaking), with a prevalence of 1–4%. In anamnesis is a typical indication of family occurrence, relief after alcohol. It can sometimes occur together with dystonia or Parkinson's disease.

Etiopathogenesis
It can start at a younger age, in the 3rd decade, but also in old age (senile tremor). The pathogenesis and localization of the disorder are not known.

Clinical picture
Tremor is typically static, kinetic and postural with a frequency of 4–12 Hz, affecting the upper limbs, the head, voice and lower limbs are less frequently affected. It manifests itself during motor activity, before its termination and usually disappears at rest. Tremor is faster than parkinsonian (6–8/s). The disability progresses slowly. The amplitude increases and the frequency decreases.

Therapy
The therapy is only symptomatic, we educate the patient about the benign nature of the disease. We only use Farmak when the symptoms bother us. The drugs of first choice are primidone and beta blockers (methipranol), a lesser effect can be expected from benzodiazepines (clonazepam, alprazolam]) or [[gabapentinu. In case of significant tremor and insufficient effectiveness of pharmacotherapy, it is appropriate to consider neurosurgery - unilateral lesion or bilateral stimulation of the ``Vim nucleus'' thalamus.

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