Therapeutic advances in tremor.

Abstract

Although tremor is a highly prevalent movement disorder, progress in this field is limited because of the poor understanding of many of the underlying conditions. This review summarizes recent treatment attempts since 2013. For essential tremor, recent innovations are phase I or II studies of Octanol, several clinically relevant refinements for deep brain stimulation, and the development of the new magnetic resonance imaging guided focused ultrasound technique. Further new invasive and noninvasive electrical and magnetic stimulation techniques have been tested for essential tremor and parkinsonian tremor. For multiple sclerosis tremor, some open-label observations have shown positive results (natalizumab, dalfampridine, levetiracetam), whereas controlled trials using cannabinoids have been negative. Functional tremor has shown a positive response to retrainment. Neuroprosthetic devices have been tested in a variety of tremor conditions. Several promising medical and surgical treatment trials are underway and will be completed shortly.