Charles P D, Esper G J, Davis T L, Maciunas R J, Robertson D
Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Am Fam Physician. 1999 Mar 15;59(6):1565-72.
Tremor is a symptom of many disorders, including Parkinson's disease, essential tremor, orthostatic tremor, cerebellar disease, peripheral neuropathy and alcohol withdrawal. Tremors may be classified as postural, rest or action tremors. Symptomatic treatment is tailored to the tremor type. Combination therapy with carbidopa and levodopa remains the first-line approach for parkinsonian tremor. Essential tremor may be amenable to propranolol or primidone. Propranolol may be useful in treating alcohol withdrawal tremor, and isoniazid may control the cerebellar tremor associated with multiple sclerosis. Clonazepam may relieve orthostatic tremor. Other agents are also available for the treatment of tremor. When medical therapy fails to control the tremor, surgical options such as thalamotomy, pallidotomy and thalamic stimulation should be considered in severe cases. Thalamic stimulation, the most recent of these surgical approaches, offers the advantage over ablative procedures of alleviating tremor without the creation of a permanent lesion.
震颤是许多疾病的症状，包括帕金森病、特发性震颤、直立性震颤、小脑疾病、周围神经病变和酒精戒断。震颤可分为姿势性、静止性或动作性震颤。对症治疗是根据震颤类型量身定制的。卡比多巴和左旋多巴联合治疗仍然是帕金森震颤的一线治疗方法。特发性震颤可能对普萘洛尔或扑米酮有效。普萘洛尔可能有助于治疗酒精戒断性震颤，而异烟肼可能控制与多发性硬化症相关的小脑震颤。氯硝西泮可能缓解直立性震颤。还有其他药物可用于治疗震颤。当药物治疗无法控制震颤时，在严重病例中应考虑丘脑切开术、苍白球切开术和丘脑刺激等手术选择。丘脑刺激是这些手术方法中最新的一种，与切除性手术相比，具有缓解震颤而不产生永久性病变的优势。
