ESSENTIAL TREMOR

Essential tremor. Essential tremor is very common in the general population. It is a postural tremor occurring in adulthood, evolving progressively and whose severity can be very variable from one individual to another. A positive effect of alcohol is often reported. Its pathophysiology remains poorly understood but candidate genes have been identified in some families. From a therapeutic point of view, a first-line treatment based on propanolol or primidone may be prescribed in case of discomfort. In case of inefficiency or intolerance, second-line treatments are available but their anti-tremor effect is very variable, depending on patients. In case of pharmacoresistance, the stimulation of the VIM nucleus of the thalamus is a very effective neurosurgical option. In the case of a contraindication to stimulation, gammaknife thalamotomy (radiosurgery) may also be considered. Recently, ultrasound thalamotomy has been shown to be a promising therapy in essential tremor.