Department of Neurology, Christian- Albrechts- University Kiel, Kiel, Germany.
Curr Opin Neurol. 2012 Aug;25(4):475-82. doi: 10.1097/WCO.0b013e3283550c7e.
This review describes the most recent advances in epidemiology, classification, genetics, pathology and treatment of essential tremor. In addition, recent advances in more rare forms of tremor are summarized.
Clinical, biochemical, pathological and imaging studies suggest an abnormal functioning of the cerebellum in essential tremor. Minor changes of cognition and personality may be due to secondary effects. Dementia and possible shortened life span seem to be limited to late-onset essential tremor. Many of these issues are not yet finally settled and need confirmation in further studies. The current essential tremor classification seems not to reflect the variety of phenotypic expressions. Regarding treatment, there is now a level B evidence for topiramate. Levetiracetam may induce a positive response in Holmes tremor, but is ineffective in orthostatic tremor.
These findings have extended our knowledge about essential tremor. It appears that a new, more distinct classification system is required. Recent treatments have remained unchanged.
本文描述了特发性震颤在流行病学、分类、遗传学、病理学和治疗方面的最新进展。此外，还总结了最近更为罕见的震颤形式的研究进展。
临床、生化、病理和影像学研究表明特发性震颤与小脑功能异常有关。认知和人格的轻微变化可能是由于次级效应。痴呆和可能缩短的预期寿命似乎仅限于发病较晚的特发性震颤。这些问题中的许多尚未最终解决，需要进一步研究证实。目前的特发性震颤分类似乎并不能反映各种表型的表达。在治疗方面，目前对于托吡酯有 B 级证据。左乙拉西坦可能会使 Holmes 震颤产生阳性反应，但对直立性震颤无效。
这些发现扩展了我们对特发性震颤的认识。似乎需要一种新的、更明确的分类系统。最近的治疗方法没有改变。
