Harmaline tremor

Although tremor is a common sign of neurological disorders, such as Parkinson\u27s disease, Wilson\u27s disease, and hereditary ataxia, most adults with clinically significant tremor have idiopathic or essential tremor (ET). While ET mainly affects the arms, the head and voice are also often involved. Mechanical loads have little effect on the frequency of ET that distinguishes ET from enhanced physiological tremor. The postural nature of ET often significantly interferes with activities of daily living such as eating and writing. For some patients, drinking from a glass without spilling becomes impossible. Persons with occupations dependent on manual dexterity such as secretaries with typing responsibilities, surgeons, and dentists may be forced into early retirement. The prevalence of ET increases with advancing age, and men seem to be affected more frequently than women. In many patients, ET improves, sometimes dramatically, after the consumption of alcoholic beverages. Medical treatments for ET include the drugs primidone and propranolol. Thalamic deep brain stimulation is employed in patients with incapacitating ET that does not respond well to medications. In many ET patients, the response to medical and surgical treatments may be inadequate, associated with significant side effects, or both. ET and harmaline tremor share numerous similarities, and the latter may be a useful tool for understanding and treating the former. © 2005 Elsevier Inc. All rights reserved