TY - JOUR
T1 - Evidence-based guideline update
T2 - Treatment of essential tremor: Report of the Quality Standards Subcommittee of the American Academy of Neurology
AU - Zesiewicz, T. A.
AU - Elble, R. J.
AU - Louis, E. D.
AU - Gronseth, G. S.
AU - Ondo, W. G.
AU - Dewey, R. B.
AU - Okun, M. S.
AU - Sullivan, K. L.
AU - Weiner, W. J.
N1 - Funding Information:
Dr. Zesiewicz serves on the speakers' bureau for and has received funding for travel and speaker honoraria from Teva Pharmaceutical Industries Ltd.; serves on the editorial board of Tremor and Other Hyperkinetic Movement Disorders ; serves/has served as a consultant for Boehringer Ingelheim, Teva Pharmaceutical Industries Ltd., Allergan, Inc., UCB, and Novartis; is listed as an inventor on a provisional patent on the use of nicotinic modulators in treating ataxia and imbalance held by the University of South Florida; and receives/has received research support from Pfizer Inc, the National Ataxia Foundation, the Friedreich's Ataxia Research Association, and the Bobby Allison Ataxia Research Center. Dr. Elble serves on the scientific advisory board for the International Essential Tremor Foundation; has received funding for travel from the Movement Disorders Society; receives research support from GlaxoSmithKline, Teva Pharmaceutical Industries Ltd., Pfizer Inc, Phytopharm, Janssen (Ortho-McNeil), the NIH/NINDS, and the Spastic Paralysis Research Foundation of Kiwanis International; and has acted as an expert witness in a medico-legal proceeding. Dr. Louis has received honoraria from the American Academy of Neurology; receives research support from the NIH/NINDS and the Parkinson's Disease Foundation; and has served as a legal consultant on epidemiologic issues. Dr. Gronseth serves on the editorial advisory board of Neurology Now , serves on the speakers' bureau for Boehringer Ingelheim, and receives research support from the American Academy of Neurology. Dr. Ondo has received speaker honoraria from GlaxoSmithKline, Boehringer Ingelheim, Allergan, Inc., Teva Pharmaceutical Industries Ltd., Novartis, Ipsen, Merz Pharmaceuticals, LLC, and Lundbeck Inc.; serves on the editorial board of Tremor and Other Hyperkinetic Movements ; receives publishing royalties for Restless Legs Syndrome: Diagnosis and Treatment (Informa, 2008) and Handbook of Movement Disorders (Wiley-Blackwell, 1998); and has received research support from Takeda Pharmaceutical Company Limited, ACADIA Pharmaceuticals, Ipsen, IMPAX Laboratories, Inc., XenoPort, Inc., Bayer Schering Pharma, and Allergan, Inc. Dr. Dewey serves on the speakers' bureaus for and has received funding for travel and speaker honoraria from Teva Pharmaceutical Industries Ltd., GlaxoSmithKline, Ipsen, Boehringer Ingelheim, and Allergan Inc.; serves as a consultant for Teva Pharmaceutical Industries Ltd.; receives research support from the NIH; and has served as an expert witness in a medico-legal case. Dr. Okun serves on scientific advisory boards for the Dystonia Medical Research Foundation and the National Parkinson Foundation and the Medical Advisory Board for the Tourette Syndrome Association; has received funding for travel and speaker honoraria from Medtronic, Inc. prior to 2010; has served/serves on the editorial boards of Neurology ® and Parkinsonism and Related Disorders ; is a founder of the COMPRESS software used for deep brain stimulation (DBS) screening and has filed patents regarding double lead DBS, DBS targeting, and COMPRESS; receives royalties from the publication of Ultimate Neurology Review (DEMOS, 2007), Parkinson's Disease (Manson, 2009), and Deep Brain Stimulation for Neurological and Psychiatric Diseases (Humana Press, 2009); serves as Medical Director of the National Parkinson Foundation and as a member of the Ask the Expert Forum; and has received research support from Medtronic, Inc. (devices and training fellowship grants), the NIH, the University of Florida Foundation, the Parkinson Alliance, the Michael J. Fox Foundation, and the National Parkinson Foundation. K.L. Sullivan reports no disclosures. Dr. Weiner has served on scientific advisory boards for Santhera Pharmaceuticals and Rexahn Pharmaceuticals, Inc.; serves on the editorial boards of Parkinsonism and Related Disorders and Neurological Reviews and as Editor of Treatment Options in Neurology ; receives royalties from the publication of Neurology for the Non-Neurologist (6th edition, Wolters Kluwer/Lippincott, 2010), Parkinson's Disease: A Complete Guide for Patients and Family (2nd edition, Hopkins University Press, 2007), and Handbook of Clinical Neurology Hyperkinetic Disorders (Elsevier, 2011); has received research support from Novartis, Santhera Pharmaceuticals, and Boehringer Ingelheim; and has provided expert testimony and served as a subject matter expert in legal proceedings.
PY - 2011/11/8
Y1 - 2011/11/8
N2 - Background: This evidence-based guideline is an update of the 2005 American Academy of Neurology practice parameter on the treatment of essential tremor (ET). Methods: A literature review using MEDLINE, EMBASE, Science Citation Index, and CINAHL was performed to identify clinical trials in patients with ET published between 2004 and April 2010. Results and Recommendations: Conclusions and recommendations for the use of propranolol, primidone (Level A, established as effective); alprazolam, atenolol, gabapentin (monotherapy), sotalol, topiramate (Level B, probably effective); nadolol, nimodipine, clonazepam, botulinum toxin A, deep brain stimulation, thalamotomy (Level C, possibly effective); and gamma knife thalamotomy (Level U, insufficient evidence) are unchanged from the previous guideline. Changes to conclusions and recommendations from the previous guideline include the following: 1) levetiracetam and 3,4-diaminopyridine probably do not reduce limb tremor in ET and should not be considered (Level B); 2) flunarizine possibly has no effect in treating limb tremor in ET and may not be considered (Level C); and 3) there is insufficient evidence to support or refute the use of pregabalin, zonisamide, or clozapine as treatment for ET (Level U).
AB - Background: This evidence-based guideline is an update of the 2005 American Academy of Neurology practice parameter on the treatment of essential tremor (ET). Methods: A literature review using MEDLINE, EMBASE, Science Citation Index, and CINAHL was performed to identify clinical trials in patients with ET published between 2004 and April 2010. Results and Recommendations: Conclusions and recommendations for the use of propranolol, primidone (Level A, established as effective); alprazolam, atenolol, gabapentin (monotherapy), sotalol, topiramate (Level B, probably effective); nadolol, nimodipine, clonazepam, botulinum toxin A, deep brain stimulation, thalamotomy (Level C, possibly effective); and gamma knife thalamotomy (Level U, insufficient evidence) are unchanged from the previous guideline. Changes to conclusions and recommendations from the previous guideline include the following: 1) levetiracetam and 3,4-diaminopyridine probably do not reduce limb tremor in ET and should not be considered (Level B); 2) flunarizine possibly has no effect in treating limb tremor in ET and may not be considered (Level C); and 3) there is insufficient evidence to support or refute the use of pregabalin, zonisamide, or clozapine as treatment for ET (Level U).
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U2 - 10.1212/WNL.0b013e318236f0fd
DO - 10.1212/WNL.0b013e318236f0fd
M3 - Article
C2 - 22013182
AN - SCOPUS:82955243943
VL - 77
SP - 1752
EP - 1755
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 19
ER -