Tremor medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment
There is no cure for most tremors. The appropriate treatment depends on accurate diagnosis of the cause. Some tremors respond to treatment of the underlying condition. For example, in some cases of psychogenic tremor, treating the patient’s underlying psychological problem may cause the tremor to disappear.
Medications
Symptomatic drug therapy is available for several forms of tremor:
- Parkinsonian tremor drug treatment involves levodopa and/or dopamine-like drugs such as pergolide mesylate, bromocriptine mesylate and ropinirole. Other drugs used to lessen parkinsonian tremor include amantadine hydrochloride and anticholinergic drugs.
- Essential tremor may be treated with propranolol, nadolol or other beta blockers and primidone, an anticonvulsant drug.
- Cerebellar tremor typically does not respond to medical treatment.
- Rubral tremor patients may receive some relief using levodopa or anticholinergic drugs.
- Dystonic tremor may respond to Valium, anticholinergic drugs, and intramuscular injections of botulinum toxin. Botulinum toxin is also prescribed to treat voice and head tremors and several movement disorders.
- Enhanced physiologic tremor is usually reversible once the cause is corrected. If symptomatic treatment is needed, beta blockers can be used.
Lifestyle
Eliminating tremor “triggers” such as caffeine and other stimulants from the diet is often recommended.
Physical therapy may help to reduce tremor and improve coordination and muscle control for some patients. A physical therapist will evaluate the patient for tremor positioning, muscle control, muscle strength, and functional skills. Teaching the patient to brace the affected limb during the tremor or to hold an affected arm close to the body is sometimes useful in gaining motion control. Coordination and balancing exercises may help some patients. Some therapists recommend the use of weights, splints, other adaptive equipment, and special plates and utensils for eating.