A patient with hypeension also suffers from essential tremor. Optimal treatment of the patient should include management with
Correct Answer: Propranolol
Description: Essential Tremor is the commonest movement disorder. It can present in childhood but dramatically increases in prevalence over the age of 70 years. ET is characterized by a high-frequency tremor (6-10 Hz) that predominantly affects the upper extremities. The tremor most often manifest as a postural or action (kinetic) tremor and, in severe cases, can interfere with functions such as eating and drinking. It is typically bilateral and symmetric but may begin on one side and remain asymmetric. TREATMENTMany cases are mild and require no treatment other than reassurance. Beta blockers and primidone are the standard drug therapies for ET and help in about 50% of cases. Propranolol (20-120 mg daily, given in divided doses) is usually effective at relatively low doses, but higher doses may be effective in some patients. The drug is contraindicated in patients with bradycardia or asthma.Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 449 Parkinson's Disease and Other Movement Disorders
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