A 45-year-old female with a past medical history of asthma is diagnosed as having essential tremor. What is the most suitable management?
Amitriptyline
Propranolol
Sodium valproate
Carbamazepine
Primidone
Dr. Kasper:
Primidone
Essential tremor is an AD condition that is made worse when arms are outstretched, made better by alcohol and propranolol
Propranolol is generally considered first-line in essential but given the history of asthma primidone should be used
Essential tremor
Essential tremor (previously called benign essential tremor) is an autosomal dominant condition which usually affects both upper limbs
Features
postural tremor: worse if arms outstretched
improved by alcohol and rest
most common cause of titubation (head tremor)
Management
propranolol is first-line
primidone is sometimes used