New Treatment Guidelines for Essential Tremor Disorder

For immediate release: October 19, 2011


Sharon Boston

[email protected] | 410-328-8919

University of Maryland School of Medicine Neurology Department Chairman Among Authors of New Treatment Guidelines

Baltimore, Md.-- New treatment guidelines for essential tremor, the most common type of tremor disorder, were published today in the on line issue of Neurology®, the medical journal of the American Academy of Neurology.  Authors included University of Maryland School of Medicine faculty William Weiner M.D., professor and chairman of neurology.  Essential tremor affects an estimated 10 million people in the United States and is often confused with other movement disorders such as Parkinson's disease.

“Essential tremor affects the hands, head and voice, so it can cause problems with basic life functions such as eating, writing or shaving. Finding the most effective treatments for people with this disorder is vital so the condition does not become debilitating,” says William Weiner, M.D., professor and chairman of neurology at the University of Maryland School of Medicine.

Dr. Weiner and his colleagues did a comprehensive review of essential tremor research and evaluated the best scientific data on treatments. According to their new findings, the high blood pressure drug propanolol and the seizure drug primidone are the most effective at improving shaking in people with essential tremor. The new guidelines also suggest the seizure drugs gabapentin and topiramate, along with the high blood pressure drugs atenolol and sotalol and the anxiety drug alprazolam, can be helpful.

“Although there are some good treatments for this disorder, not all people with essential tremor see benefit from these drugs,” explains Dr. Weiner, director of the Maryland Parkinson's Disease and Movement Disorders Center at the University of Maryland Medical Center. “Through our review, we found that more and better research is needed to help those people who are not getting good results from current treatment options. It is also important for these patients to work with their neurologists to explore other types of treatments, such as surgery.”

The American Academy of Neurology reviewers found that two types of surgery, deep brain stimulation and thalamotomy, may be helpful for certain patients.

The current review differs from previous guidelines in that it does not recommend using the seizure drugs levetiracetam and flunarizine or the drug 3,4-diaminopyridine (used in rare muscle diseases) to treat tremors in the arms and legs. In addition, the updated guideline found insufficient evidence to support using clozapine, a schizophrenia medication, to help people with essential tremor.

“Because medicine is advancing all the time, it is important for neurologists do these periodic reviews so physicians can have the most up-to-date information to help their patients,” says Dr. Weiner.

The faculty physicians and staff at the University of Maryland Department of Neurology are internationally renowned for their expertise and research in movement disorders.  Involvement in important projects such as these American Academy of Neurology guidelines reflects our commitment to advancing the practice of medicine and finding answers for people who are living with potential debilitating medical conditions,” says E. Albert Reece, M.D., Ph.D., M.B.A, vice president for medical affairs, University of Maryland, and dean, University of Maryland School of Medicine.

Essential tremor usually starts after age 40, although it is most common in people over age 65. The main symptom is involuntary shaking, usually most noticeable in the hands, although it can affect the arms, eyelids or other muscles. The tremor may be not affect opposite sides of the body in the same way. It is often misdiagnosed as Parkinson`s disease so it is important to make sure the diagnosis is correct.

To see the American Academy of Neurology guidelines or summaries designed for patients and their families, go to For more information on the University of Maryland Parkinson's Disease and Movement Disorders Center, go to


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