マラソンレクチャー
本態性振戦の診断と治療
キーワード:
essential tremor,
Parkinson disease,
dystonia,
propranolol,
magnetic resonance guided focused ultrasound (MRgFUS)
2018 年 34 巻 4 号 p. 364-367
詳細
2018 年 34 巻 4 号 p. 364-367
Essential tremor (ET) is most frequent movement disorder in individuals above 40 years old. The prevalence of ET increases steeply with increasing ages. ET is slowly progressive disorder which is sometimes causing severe disability but is not life–limiting.
Diagnosis of ET is based on clinical examination and neurological history, as a specific biological marker or diagnostic test is not available. Differences among tremor disorders are important in published clinical criteria for ET. In pharmacotherapy, Propranolol and Primidone have level A recommendations. And Topiramate and Gabapentin have level B recommendations. However, drugs for ET is not enough reduction of tremor and side–effects is common. Botulinum toxin is possibly effective. Vim thalamotomy is highly effective but side–effects of surgery should be considered. Noninvasive functional neurosurgery using transcranial MRI guided focus ultrasound is a novel treatment and will become a new option near future.
