Essential tremor responsive to levetiracetam

Abstract

Essential tremor is one of the most common movement disorders with a prevalence of 0.4% to 3.9% in the general population and increases with age. The medical treatment available for patients with essential tremor is often inadequate. Propranolol and primidone are the first-line treatment options, improving in up to two thirds of cases. This article reports a satisfying response to levetiracetam with disabling essential tremor in a 58-year-old man whom propranolol as well as primidone had to be discontinued due to unresponsiveness and severe side effects. One of the antiepileptic drugs, levetiracetam, may be more useful in the treatment of essential tremor.

Keywords

• Essential tremor, anticonvulsant drug, levetiracetam

Levetirasetama cevap veren esansiyel tremor

Öz

Esansiyel tremor, genel popülasyonda prevelansı % 0.4-3.9 olan ve yaş ile artan en sık görülen hareket bozukluğudur. Esansiyel tremorlu hastaların medikal tedavileri sıklıkla yetersizdir. Propranolol ve primidon vakaların 2/3\'de ilk tercih tedavilerdir. Bu yazı, propranolol ve primidonu yanıtsızlık ve yan etkiler nedeni ile kesilen levetirasetama iyi cevap veren sakatlayıcı esansiyel tremorlu 58 yaşındaki bir erkek hastayı rapor etmektedir. Antiepileptik ilaçlardan biri olan levetirasetam, esansiyel tremor tedavisinde daha fazla yararlı olabilmektedir.

Anahtar Kelimeler

• Esansiyel tremor, antikonvülzan ilaç, levetirasetam

Kaynakça

1. Whaley NR, Putzke JD, Baba Y, Wszolek ZK, Uitti RJ. Essential tremor: phenotypic expression in a clinical cohort. Parkinsonism Relat Disord 2007; 13(6):333–9.
2. Louis ED. Clinical practice: Essential tremor. N Engl J Med 2001; 345(12):887-91.
3. Fahn SE, Tolosa E, Marin C. Clinical rating scale for tremor. In: Jankovic J, Tolosa E, eds. Parkinson’s Dis- ease and Movement Disorders, 2nd edn. Baltimore: Williams & Wilkins, 1998:225-34.
4. Johannessen Landmark C. Antiepileptic drugs in non- epilepsy disorders: relations between mechanisms of action and clinical efficacy. CNS Drugs 2008; 22(1):27-47.
5. Ondo WG. Essential tremor: treatment options. Curr Treat Options Neurol 2006; 8(3):256-67.
6. Sanz-Cartagena P, Fossas P, Floriach-Robert M, Cano A, Palomeras E. Effectiveness and safety of leveti- racetam in patients with essential tremor: data from an open 11-week follow-up trial. Rev Neurol 2007; 45(3):134-6.
7. Kralic JE, Criswell HE, Osterman JL, et al. Genetic es- sential tremor in gamma-aminobutyric acidA receptor alpha1 subunit knockout mice. J Clin Invest 2005; 115(3):774-9.
8. Saponara R, Greco S, Proto G, Trubia T, Domina E. Levetiracetam improves intention tremor in fragile x- associated tremor/ataxia syndrome. Clin Neurophar- macol 2009; 32(1):53-4.

9. Ferlazzo E, Morgante F, Rizzo V, et al. Successful treat- ment of Holmes tremor by levetiracetam. Mov Disord 2008; 23(14):2101-3.
10. Bushara KO, Malik T, Exconde RE. The effect of le- vetiracetam on essential tremor. Neurology 2005; 64(6):1078-80.
11. Elble RJ, Lyons KE, Pahwa R. Levetiracetam is not effective for essential tremor. Clin Neuropharmacol 2007; 30(6):350-6.