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Treatment of Essential and Other Tremor Disorders

Treatments available include behavioral, medication, and surgery.

Behavioral Treatment
This includes removing things that can increase tremor:

  • Medications
  • Stress
  • Caffeine


Medical Treatment
Medications used to treat tremor include the following:

  • Propranolol and primidone have been used successfully for a long time
  • If propranolol and primidone not effective then sotolol, atenolol and alprazolam may be tried.
  • Newer medications include gabapentin and topiramate
  • Botulinum toxin injections may also be used to temporarily weaken the muscles involved in the tremor to slow it down


Surgical treatment

  • Thalamic deep brain stimulation (DBS) surgery has been safely and effectively used to treat essential and other tremors for 20 years.

Patients with essential and other tremors are considered candidates for deep brain stimulation if their tremors are uncontrolled despite adequate trials of several medications. A patient is also a candidate if he or she experiences medication side effects, such as slow heartbeat or sleepiness.

Deep brain stimulation can dramatically reduce hand tremor in those people with essential tremor. In many cases, the tremor can be eliminated. Most people acquire at least 75% relief. This may last for many years, with occasional programming adjustments needed to maintain the effects.

Tremor due to other causes (multiple sclerosis, brain trauma) is more difficult to control, requires more frequent programming adjustments, and may only provide 50% tremor relief. However, this may be a significant aid to someone who is disabled by tremor.

You may e-mail dbs@northwestern.edu for more information about functional neurosurgery for essential and other tremor disorders.