Resumo
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- tremor postural e/ou cinético
- problemas de motricidade fina
Other diagnostic factors
- diminuição do tremor após o consumo de álcool, benzodiazepínicos, barbitúricos ou gabapentina
- tremor na cabeça ou voz
- tremor de repouso
Risk factors
- idade avançada
- história familiar
- ascendência branca
- exposição a toxinas ambientais
Diagnostic tests
1st tests to order
- diagnóstico clínico
Tests to consider
- tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM) do crânio
- ceruloplasmina sérica
- cobre urinário de 24 horas
- testes da função tireoidiana
- estudos fisiológicos de tremores
- TC por emissão de fóton único (SPECT) do crânio
Emerging tests
- índice de estabilidade do tremor
Treatment algorithm
sem disfunção ou constrangimento
disfunção ou constrangimento
Contributors
Authors
Sheng-Han Kuo, MD
H. Houston Merritt Associate Professor of Neurology
College of Physicians and Surgeons
Columbia University
New York
NY
Disclosures
SHK is an author of a number of references cited in this topic.
Ming-Kai Pan, MD, PhD
Associate Professor of Pharmacology
College of Medicine
National Taiwan University
Taipei
Taiwan
Disclosures
MKP is a consultant of BioPro Scientific, Taiwan, and Sumitomo Pharma Co., Japan. MKP is an author of a number of references cited in this topic.
Acknowledgements
Dr Sheng-Han Kuo and Dr Ming-Kai Pan would like to gratefully acknowledge Dr Zoltan Mari, Dr Martin Kronenbuerger, Dr Adam Burdick, and Dr Kelly D. Foote, previous contributors to this topic.
Disclosures
ZM has directed various educational programmes, accredited (CME) by Johns Hopkins University, and has accepted honoraria for consulting. MK, AB, and KDF declare that they have no competing interests.
Peer reviewers
Katherine Longardner, MD
Assistant Clinical Professor
University of California San Diego
San Diego
CA
Disclosures
KL was a paid consultant for Boston Scientific.
Roger Weis, MD
Pediatric Neurologist
Kinderneurologisches Zentrum Mainz
Mainz
Germany
Disclosures
RW declares that he has no competing interests.
Cory Toth, BSc, MD, FRCP(C)
Assistant Professor of Neurosciences
Hotchkiss Brain Institute
University of Calgary
Alberta
Canada
Disclosures
CT declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Deuschl G, Bain P, Brin M; Ad Hoc Scientific Committee. Consensus statement of the Movement Disorder Society on tremor. Mov Disord. 1998;13(suppl 3):2-23. Abstract
Ferreira JJ, Mestre TA, Lyons KE, et al. MDS evidence-based review of treatments for essential tremor. Mov Disord. 2019 Jul;34(7):950-8. Abstract
Zesiewicz TA, Elble RJ, Louis ED, et al. Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology. 2011 Nov 8;77(19):1752-5.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Doença de Parkinson
- Distonia
- Doença de Wilson
More DifferentialsGuidelines
- Suspected neurological conditions: recognition and referral
- American Society for Stereotactic and Functional Neurosurgery position statement on magnetic resonance-guided focused ultrasound for the management of essential tremor
More GuidelinesPatient information
Tremor essencial
More Patient information
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