Saturday, July 21, 2012

Q: 76 year old male is admitted in ICU for Bradycardia secondary to beta-blocker prescribed for his essential tremor. You received nursing call at night that patient is now requesting alcohol to abort his symptoms of essential tremor as it is always helpful to him?

Answer: It is true that Alcohol decrease the synptoms of essential tremor. The mechanism of tremor reduction by alcohol is unknown.

The recommeded treatment is propranolol. And if propranolol is contraindicated, primidone is an alternative choice. Other drugs which have shown effects include Gabapentin, Clonazepam or Topiramate.

Surgical treatment is reserved for the severe cases include thalamotomy and deep brain stimulation.

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