Familial Essential Tremor

Dear Ask The Doctor: My mother is 86 years of age and was diagnosed with "Beign Hereditary Tremors" app. 15 years ago. Yes, this does run in her family. She is one of 8 children and 4 of them suffered with this illness. She has been under the care of a neurologist and her family doctor. Both have agreed that diazapam and propandonlol (spelling?) is the only medication for the shaking. They do not work!! She has taken them for years. Mom's shaking is confined to her hands and it's very hard for her to function on a daily basis. What can you advise us to do? She lives alone. Thanks so much

Dear Gwen: Familial Essential Tremor which usually begins in one upper extremity and soon affects the other. Essential tremor rarely extends from the upper extremity to the ipsilateral leg. Tremor may be intermittent initially, emerging only during periods of emotional activation. Over time the tremor becomes persistent. A degree of voluntary control is typical, and the tremor may be suppressed by skilled manual tasks and during sleep. Primidone and Propanolol are the 2 medications that have provided benefit in reducing tremor amplitude in roughly 75% of affected individuals. Alcohol also improve the tremors for an unknown mechanism. Other medications have been used: Topiramate, Clozapine, Gabapentin and some benzodiazepines as clonazepam and alprazolam that basically reduce the anxiety. In the view that Essential Tremor is slowly progressive, the medications may need to be adjusted over the time, and also if the medication loses benefit may be should be changed. I recommend that your mother should be evaluated by a neurologist to consider the other treatment possibilities available.