Dr. Duarte Machado is associate medical director for the Hartford HealthCare David and Rhoda Chase Movement Disorders Center. He has the basics on essential tremor, and new treatments for it.
Q: What are essential tremors?
A: Essential tremor is an extremely common movement disorder that most commonly presents as an action or postural tremor in the arm, hands, or head. Imaging studies suggest that essential tremor is correlated with neurodegeneration in a part of the brain called the cerebellum.
Q: How are tremor disorders managed?
A: Current first-line medications include beta-blockers such as propranolol and anti-epileptics such as primidone. However, these medications are only partially effective at controlling tremors.
Q: You recently completed a clinical trial using botulinum toxin to treat essential tremors. Describe the study.
A: In the event that oral medications fail to manage symptoms, botulinum toxin can be injected into the affected muscles. This study is the first double-blinded study to determine the efficacy of incobotulinumtoxinA (Xeomin) as a treatment for essential tremor using a customized injection strategy for each patient.
Q: What were the study findings?
A: The results have recently been submitted for publication. What I saw was a statistically significant number of patients (48%) experienced improvement of tremor after Xeomin injection as compared to placebo (14%) injection (p=0.043 by Fisher exact test). What’s more, patients tolerated this well without the level of side effect seen in earlier studies. This is now a treatment that my colleague, Dr. J. Antonelle de Marcaida, and I are offering to any patient at the Hartford Healthcare Movement Disorders Center.
To reach the David and Rhoda Movement Disorders Center, with offices in Vernon and Cheshire, please call 860.870.6385, or 1.877.HHC.HERE (1.877.442.4373).
