Therapy for tremor (shaking) depends on the cause.
General measures
- Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
- Limited caffeine consumption (max. 240 mg caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
Drug therapy
- Essential tremor:
- Propranolol (beta-blocker): note: discontinue gradually (wg rebound effect); potency: 32-75% (first-line agent in younger patients).
- Primidone (anticonvulsant): potency: 42-76% (first-line agent in older patients because of higher likelihood of cardiac or pulmonary history).
- Topiramate (antiepileptic): potency: 30-41%.
If under therapy with propranolol or primidone or the combination of propanolol with primidone no satisfactory effect or unacceptable side effects occur is a surgical indication (see below) to consider.
Surgical therapy
- Essential tremor:
- Deep brain stimulation (see below the title of the same name).
- Ultrasound thalamotomy (stereotactic surgery non-invasive with focused ultrasound (FUS) in an MRI scanner), as ultima ratio therapy.
- Parkinsonian tremor: ultrasound thalamotomy (target region: nucleus ventrointermedius internus (VIM) ; see above) Side effect under FUS: 30-40% transient paresthesias and ataxias.
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
- Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grains, vegetables).
- Other specific dietary recommendations depending on the cause of tremor (tremor).
- Selection of appropriate foods based on the nutritional analysis.
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
