Esansiyel Tremor Tedavisi
Özet
Esansiyel tremor (ET), yaşla birlikte görülme sıklığı artan ve toplumda yaygın görülen hareket bozukluklarındandır. Klinik ve tedavi yaklaşımlarının güncel kılavuzlar eşliğinde incelendiği bu bölümde birinci basamak tedavi olarak propranolol ve primidonun etkinliği vurgulanırken, alternatif farmakolojik ajanlar (topiramat, gabapentin vb.) ve botulinum toksin uygulamaları değerlendirilmektedir. Medikal tedaviye dirençli ve fonksiyonel kısıtlılığı olan hastalarda, talamusun ventralis intermedius (VİM) nükleusunu hedefleyen Derin Beyin Stimülasyonu (DBS), radyofrekans talamotomi, stereotaktik radyocerrahi ve Manyetik Rezonans Görüntüleme Rehberliğinde Fokus Ultrason (MRgFUS) gibi cerrahi yöntemler ve yeni tedavi stratejileri incelenmiştir. Hastalık progresyonu, tedavinin etkinliği veya tedavi yan etkileri olabileceğinden klinik izlemde tüm tedavi seçenekleri tekrar gözden geçirilip kişiye özel tedavi düzenlenmelidir.
Referanslar
Song, P., et al., The global prevalence of essential tremor, with emphasis on age and sex: A meta-analysis. J Glob Health, 2021. 11: p. 04028.
Ozel, L., et al., Investigation of the prevalence of essential tremor in individuals aged 18-60 in Erzurum. Acta Neurol Belg, 2013. 113(2): p. 127-31.
Sur, H., et al., Prevalence of essential tremor: a door-to-door survey in Sile, Istanbul, Turkey. Parkinsonism Relat Disord, 2009. 15(2): p. 101-4.
Güler, S., et al., The prevalence of essential tremor in Edirne and its counties accompanied comorbid conditions. Neurol Res, 2019. 41(9): p. 847-856.
Louis, E.D., The Roles of Age and Aging in Essential Tremor: An Epidemiological Perspective. Neuroepidemiology, 2019. 52(1-2): p. 111-118.
Haubenberger, D. and M. Hallett, Essential Tremor. N Engl J Med, 2018. 378(19): p. 1802-1810.
Mostile, G. and J. Jankovic, Alcohol in essential tremor and other movement disorders. Mov Disord, 2010. 25(14): p. 2274-84.
Bhatia, K.P., et al., Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society. Mov Disord, 2018. 33(1): p. 75-87.
Gupta, H.V., et al., Exploring essential tremor: Results from a large online survey. Clin Park Relat Disord, 2021. 5: p. 100101.
Angelini, L., et al., Longitudinal study of clinical and neurophysiological features in essential tremor. Eur J Neurol, 2023. 30(3): p. 631-640.
Gutierrez, J., et al., Worse and Worse and Worse: Essential Tremor Patients' Longitudinal Perspectives on Their Condition. Front Neurol, 2016. 7: p. 175.
Holtbernd, F. and N.J. Shah, Imaging the Pathophysiology of Essential Tremor-A Systematic Review. Front Neurol, 2021. 12: p. 680254.
Siokas, V., et al., Genetic Risk Factors for Essential Tremor: A Review. Tremor Other Hyperkinet Mov (N Y), 2020. 10: p. 4.
Skuladottir, A.T., et al., GWAS meta-analysis reveals key risk loci in essential tremor pathogenesis. Commun Biol, 2024. 7(1): p. 504.
Louis, E.D., et al., Correlates of functional disability in essential tremor. Mov Disord, 2001. 16(5): p. 914-20.
Tröster, A.I., et al., Quality of life in Essential Tremor Questionnaire (QUEST): development and initial validation. Parkinsonism Relat Disord, 2005. 11(6): p. 367-73.
Zesiewicz, T.A., et al., Practice parameter: therapies for essential tremor [RETIRED]: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 2005. 64(12): p. 2008-20.
Zesiewicz, T.A., et al., Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology, 2011. 77(19): p. 1752-5.
Zappia, M., et al., Treatment of essential tremor: a systematic review of evidence and recommendations from the Italian Movement Disorders Association. J Neurol, 2013. 260(3): p. 714-40.
Ferreira, J.J., et al., MDS evidence-based review of treatments for essential tremor. Mov Disord, 2019. 34(7): p. 950-958.
Vetterick, C., et al., The Hidden Burden of Disease and Treatment Experiences of Patients with Essential Tremor: A Retrospective Claims Data Analysis. Adv Ther, 2022. 39(12): p. 5546-5567.
Calzetti, S., et al., Effect of a single oral dose of propranolol on essential tremor: a double-blind controlled study. Ann Neurol, 1983. 13(2): p. 165-71.
Koller, W.C. and B. Vetere-Overfield, Acute and chronic effects of propranolol and primidone in essential tremor. Neurology, 1989. 39(12): p. 1587-8.
Diaz, N.L. and E.D. Louis, Survey of medication usage patterns among essential tremor patients: movement disorder specialists vs. general neurologists. Parkinsonism Relat Disord, 2010. 16(9): p. 604-7.
Kapinos, K.A. and E.D. Louis, Prescription Drug Utilization among Patients with Essential Tremor: A Cross-Sectional Study of More Than 36,000 Patients. Mov Disord Clin Pract, 2024. 11(10): p. 1203-1211.
Ondo, W.G., et al., Topiramate in essential tremor: a double-blind, placebo-controlled trial. Neurology, 2006. 66(5): p. 672-7.
Gironell, A., et al., A randomized placebo-controlled comparative trial of gabapentin and propranolol in essential tremor. Arch Neurol, 1999. 56(4): p. 475-80.
Zhang, J., et al., Treatment for essential tremor: a systematic review and Bayesian Model-based Network Meta-analysis of RCTs. EClinicalMedicine, 2024. 77: p. 102889.
Gunal, D.I., et al., New alternative agents in essential tremor therapy: double-blind placebo-controlled study of alprazolam and acetazolamide. Neurol Sci, 2000. 21(5): p. 315-7.
Voller, B., et al., Dose-escalation study of octanoic acid in patients with essential tremor. J Clin Invest, 2016. 126(4): p. 1451-7.
Haubenberger, D., et al., Octanoic acid in alcohol-responsive essential tremor: a randomized controlled study. Neurology, 2013. 80(10): p. 933-40.
Shill, H.A., et al., Open-label dose-escalation study of oral 1-octanol in patients with essential tremor. Neurology, 2004. 62(12): p. 2320-2.
Bushara, K.O., et al., Pilot trial of 1-octanol in essential tremor. Neurology, 2004. 62(1): p. 122-4.
Kapinos, K.A. and E.D. Louis, Odds of Medical Comorbidities in Essential Tremor: Retrospective Analysis of a Large Claims Database in the United States. Neuroepidemiology, 2023. 57(3): p. 148-155.
Liao, Y.H., C.T. Hong, and T.W. Huang, Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials. Toxins (Basel), 2022. 14(3).
Alonso-Navarro, H., et al., Current and Future Neuropharmacological Options for the Treatment of Essential Tremor. Curr Neuropharmacol, 2020. 18(6): p. 518-537.
Zhang, L., et al., The research focus and frontiers in surgical treatment of essential tremor. Front Neurol, 2024. 15: p. 1499652.
Kaplitt, M.G., et al., Safety and Efficacy of Staged, Bilateral Focused Ultrasound Thalamotomy in Essential Tremor: An Open-Label Clinical Trial. JAMA Neurol, 2024. 81(9): p. 939-946.
Krack, P., et al., Current applications and limitations of surgical treatments for movement disorders. Mov Disord, 2017. 32(1): p. 36-52.
Krauss, J.K., et al., Technology of deep brain stimulation: current status and future directions. Nat Rev Neurol, 2021. 17(2): p. 75-87.
Cury, R.G., et al., Thalamic deep brain stimulation for tremor in Parkinson disease, essential tremor, and dystonia. Neurology, 2017. 89(13): p. 1416-1423.
Ondo, W., et al., Unilateral thalamic deep brain stimulation for refractory essential tremor and Parkinson's disease tremor. Neurology, 1998. 51(4): p. 1063-9.
Wakim, A.A., et al., Direct targeting of the ventral intermediate nucleus of the thalamus in deep brain stimulation for essential tremor: a prospective study with comparison to a historical cohort. J Neurosurg, 2022. 136(3): p. 662-671.
Schlaier, J., et al., Deep brain stimulation for essential tremor: targeting the dentato-rubro-thalamic tract? Neuromodulation, 2015. 18(2): p. 105-12.
Kvernmo, N., et al., Deep Brain Stimulation for Arm Tremor: A Randomized Trial Comparing Two Targets. Ann Neurol, 2022. 91(5): p. 585-601.
Barbe, M.T., et al., DBS of the PSA and the VIM in essential tremor: A randomized, double-blind, crossover trial. Neurology, 2018. 91(6): p. e543-e550.
Blomstedt, P., U. Sandvik, and S. Tisch, Deep brain stimulation in the posterior subthalamic area in the treatment of essential tremor. Mov Disord, 2010. 25(10): p. 1350-6.
Jankovic, J., et al., Outcome after stereotactic thalamotomy for parkinsonian, essential, and other types of tremor. Neurosurgery, 1995. 37(4): p. 680-6; discussion 686-7.
Mohadjer, M., et al., Long-term results of stereotaxy in the treatment of essential tremor. Stereotact Funct Neurosurg, 1990. 54-55: p. 125-9.
Mohammed, N., D. Patra, and A. Nanda, A meta-analysis of outcomes and complications of magnetic resonance-guided focused ultrasound in the treatment of essential tremor. Neurosurg Focus, 2018. 44(2): p. E4.
Iorio-Morin, C., et al., Radiosurgical thalamotomy for essential tremor: state of the art, current challenges and future directions. Expert Rev Neurother, 2024. 24(6): p. 597-605.
Bilski, M., et al., Stereotactic radiosurgery in the treatment of essential tremor - a systematic review. Front Neurol, 2024. 15: p. 1370091.
Castrillo-Fraile, V., et al., Tremor Control Devices for Essential Tremor: A Systematic Literature Review. Tremor Other Hyperkinet Mov (N Y), 2019. 9.
Mugge, W., et al., Essential Tremor Suppression with a Novel Anti-Tremor Orthosis: A Randomized Crossover Trial. Mov Disord, 2025. 40(3): p. 445-455.
Pascual-Valdunciel, A., et al., Peripheral electrical stimulation to reduce pathological tremor: a review. J Neuroeng Rehabil, 2021. 18(1): p. 33.
Okelberry, T., K.E. Lyons, and R. Pahwa, Updates in essential tremor. Parkinsonism Relat Disord, 2024. 122: p. 106086.
Pahwa, R., et al., An Acute Randomized Controlled Trial of Noninvasive Peripheral Nerve Stimulation in Essential Tremor. Neuromodulation, 2019. 22(5): p. 537-545.
Abramavičius, S., et al., Local Vibrational Therapy for Essential Tremor Reduction: A Clinical Study. Medicina (Kaunas), 2020. 56(10).
Lora-Millán, J.S., et al., Mechanical vibration does not systematically reduce the tremor in essential tremor patients. Sci Rep, 2019. 9(1): p. 16476.
