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How do you treat essential tremor?

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The mainstay maintenance therapy of essential tremor is primidone and propranolol, explains Medscape. These drugs reduce symptoms in 50 to 70 percent of patients. Other medications include topiramate, clozapine, mirtazapine, gabapentin, benzodiazepines and botulinum toxin. Surgical intervention is reserved for individuals who do not benefit from medical therapy.

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Younger patients usually begin therapy with propranolol to avoid the sedative effects of primidone, according to Medscape. Older patients start therapy with primidone to avoid the side effects of propranolol that are more prominent with age. Topiramate is an anticonvulsant medication that is sometimes used but has serious cognitive side effects that make it unappealing for many patients.

Surgical intervention includes stereotactic thalamotomy and thalamic deep brain stimulation, advises Medscape. Stereotactic thalamotomy takes two to three hours to perform and involves the destruction of a portion of the thalamus, according to WebMD. Approximately 80 percent of patients who undergo this procedure experience significant long-term relief.

Thalamic deep brain stimulation is a surgical procedure that involves placement of electrodes on the thalamus, explains WebMD. The electrodes are connected to a device implanted under the skin below the collarbone, which sends impulses to the thalamus that block the symptoms of tremor. This device has a similar effect to stereotactic thalamotomy but does not require the destruction of the thalamus and can be removed at any time.

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