14
Management
Figure 1. Overview of Management of Essential Tremor
At any time during steps 3-5:
› Assistive devices can be used
› Discussions with patients regarding social stigmas, and for
severe cases, social security/disability support
DBS, FUS or other surgical approaches
TAPS and/or other non-invasive devices (if not
added during Step 3)
Second-line and third-line pharmacological
approaches: topiramate, gabapentin, other
beta blockers, or benzodiazepines
First-line pharmacological approaches:
propranolol, primidone, or a combination
Optional add-ons: TAPS and/or other
non-invasive devices
Rule out other causes of tremor, such as
medications, Parkinson's disease, dystonia, etc.
Examination to establish presence of tremor
STEP 1
STEP 2
STEP 3
STEP 4
STEP 5
