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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The relationship between essential tremor (ET) and migraine was investigated in a prospective study. In a group of 74 ET patients 36.5% had migraine compared with 17.7% of 102 control subjects without tremor. In a group of 58 patients with migraine 17.2% had ET compared with 1.2% of 85 controls without migraine. The prevalence of ET in migraine controls was greater than controls without migraine (22% compared with 1%; p = 0.002). It is concluded that there is an association between essential tremor and migraine.
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PMID:Correlation between essential tremor and migraine headache. 229 98

In 1988 the fourth Joint National Committee (JNC IV) issued new guidelines for the detection, evaluation, and treatment of hypertension. Pharmacologic along with nonpharmacologic therapy is indicated for hypertensive patients whose diastolic blood pressures average greater than or equal to 95 mmHg over a period of time and for patients who have a diastolic blood pressure of 90 mmHg to 94 mmHg with evidence of target organ disease and/or other major risk factors. In the absence of target organ disease and/or other major risk factors, a trial of nonpharmacologic treatment is recommended for patients with a diastolic blood pressure of 90 mmHg to 94 mmHg. The JNC IV report recommends initiating pharmacologic treatment with any one of the following classes of drugs: diuretics, beta blockers, calcium channel blockers, or ACE inhibitors. In general, diuretics and calcium channel blockers are especially indicated for elderly and black patients and beta blockers and ACE inhibitors for young and white patients, but there are many exceptions. In selecting the appropriate step-one agent for a given patient, the therapeutic "two-for-one" concept is emphasized whereby one antihypertensive drug may also be beneficial for a coexisting condition. Examples are: diuretics or ACE inhibitors in congestive heart failure; calcium channel blocking drugs or beta blockers in angina pectoris or paroxysmal supraventricular tachycardia; and beta blockers for migraine headache or senile tremor.
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PMID:Mild hypertension: critical analysis of different therapeutic approaches. 266 23

The paper provides a survey of neuropharmacological fundamentals for the use of beta-adrenolytics in the treatment of psychiatric and neurological diseases. In particular there are discussed results of animal- and clinical-pharmacological experiments carried out in order to assess the influence of betaadrenolytics in disorders and diseases such as anxiety, psychoses, tremor, some kinds of addiction, migraine and epilepsy. The conclusion is that in spite of some ascertained clinical indications on the one hand and a variety of neuropharmacological results on the other the mode of action of betaadrenolytics at the level of the CNS remains still insufficiently explainable.
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PMID:[The neuropharmacology of beta adrenolytics]. 286 12

The 1984 report of the Joint National Committee on Detection, Evaluation, and Treatment of Hypertension for the first time recommended beta blockers as an alternative to diuretics for step 1 of stepped-care treatment. Numerous studies have shown that beta blockers are as effective as diuretics for monotherapy in patients with mild hypertension. They are the only antihypertensive drugs that have been shown to be cardioprotective following a myocardial infarction. Beta blockers are especially indicated for step 1 therapy in young patients (particularly those with evidence of hyperkinetic circulation), in patients who have had a myocardial infarction, and in patients with angina, migraine, or hereditary tremor because they are helpful in treating these conditions as well as in managing hypertension. Angiotensin converting enzyme inhibitors and calcium channel blockers are challenging beta blockers and diuretics as the drugs of choice for initial therapy of hypertension in selected patients. Time will ultimately determine the relative roles of each as step 1 therapy.
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PMID:Management of hypertension. What is the role of beta blockers? 289 61

We describe the basic pharmacological principles underlying the activity of the alpha 2-adrenergic receptor agonist clonidine, including its interactions with the cholinergic, histaminergic, serotoninergic, endorphinergic and possibly dopaminergic systems. The use of clonidine for the therapy of various neuropsychiatric indications in which it appears to be beneficial is described. These conditions include migraine, Korsakoff's psychosis, Tourette's syndrome, withdrawal states, tardive dyskinesia, essential tremor, neuroleptic-induced akathisia, neurogenic bladder, idiopathic orthostatic hypotension, paroxysmal localised hyperhydrosis, diabetic neuropathy and stiff-man syndrome. The need for long term evaluation of this agent in some of these diseases is stressed.
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PMID:Clonidine in neuropsychiatric disorders: a review. 330 32

The therapeutic indications for propranolol have been steadily increasing in recent years. Propranolol and other beta-adrenergic blocking agents are now generally acknowledged to be helpful in the management of hypertension, certain cardiac arrhythmias, migraine, essential tremor, angina pectoris, and most recently, immediately after myocardial infarction (Frishman, 1981; Norwegian Multicenter Study Group, 1982). Because of the myriad clinical settings in which propranolol has been found to be of benefit, the interactions of these drugs with other commonly utilized pharmacological agents is of great pragmatic interest. In this report we describe the successful concomitant clinical use of propranolol and an antidepressant drug. This finding is also of interest because of recent theories concerning the mechanism of action of antidepressant drugs. Because propranolol readily penetrates into the CNS, it blocks beta-adrenergic receptors in both the periphery and the CNS (Weiner, 1980). Much attention has been focused recently on the effects of long-term antidepressant therapy on central beta-adrenergic receptors in the brain as a possible mechanism of action of these drugs. The concurrent use of propranolol and an antidepressant drug in the patient described in this report did not attenuate the therapeutic effects of the antidepressant.
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PMID:Concurrent use of antidepressants and propranolol: case report and theoretical considerations. 683 Sep 33

A mother and son suffer from hemiplegic migraine with onset in childhood. Both have nystagmus which has not changed for many years, but the date of onset is uncertain. They have an asymmetrical tremor, clinically indistinguishable from essential tremor. Neuroophthalmological examination revealed inability to produce smooth pursuit, gaze-paretic nystagmus, rebound nystagmus, failure of fixation suppression of the vestibuloocular reflex both horizontally and vertically, and low gain of the optokinetic system. These abnormalities, confirmed by electrooculography, are commonly seen in disease of the cerebellum and brainstem. Treatment with propranolol and pizotyline lessened the number of episodes of hemiplegia and improved the tremor. Hemiplegic migraine has been reported in association with nystagmus, retinal degeneration, deafness, and ataxia in varying combinations in three other families with autosomal dominant inheritance. These associated neurological manifestations likely represent system degenerations rather than the effect of repeated ischemia imputable to the migraine itself. The syndrome of hemiplegic migraine, tremor, and ocular smooth pursuit system disorder seen in this family appears to be inherited as a single autosomal dominant trait, although more than one autosomal dominant gene may be involved.
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PMID:An autosomal dominant syndrome of hemiplegic migraine, nystagmus, and tremor. 743 78

We report a family with dominantly inherited migraine headaches, episodic vertigo, and essential tremor. All symptoms improved with the use of acetazolamide. Linkage analysis ruled out linkage to markers on chromosome 19p, known to be linked to the genetic defect in families with the clinically similar syndromes of hemiplegic migraine and periodic ataxia. This genetic heterogeneity of migraine syndromes could result from defects in a family of genes coding proteins with similar properties.
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PMID:Familial migraine with vertigo and essential tremor. 861 12

Serotonin syndrome, a condition with numerous clinical neurological manifestations, is the result of central serotonergic hyperstimulation. Features of the syndrome include mental status and behavioral changes (agitation, excitement, hypomania, obtundation), motor system involvement (myoclonus, hemiballismus, tremor, hyperreflexia, motor weakness, dysarthria, ataxia) and autonomic symptoms (fever, chills, diarrhea). Serotonin syndrome has been reported exclusively in patients on medications for psychiatric illness and Parkinsonism, despite the fact that the putative action of many antimigraine agents also involves the serotonin system. We herein report six patients with migraine who developed symptoms suggestive of the serotonin syndrome. Five were taking one or more serotomimetic agents for migraine prophylaxis (sertraline, paroxetine, lithium, imipramine, amitriptyline). In each case the symptoms and signs developed in close temporal proximity with use of a migraine abortive agent known to interact with serotonin receptors. In three instances the agent was subcutaneous sumatriptan and, in three, intravenous dihydroergotamine. In each instance the symptoms were transient and there was full recovery. With the ever increasing use of migraine medications active at serotonin receptor sites, cases of serotonin syndrome will likely occur more frequently. It is important that physicians treating migraine are aware of the serotonin syndrome and are able to recognize its varying presentations.
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PMID:Serotonin syndrome complicating migraine pharmacotherapy. 886 67

In 1962 propranolol, the first beta adrenoceptor antagonist (beta blocker), was brought on to the market. There is now a host of different beta blockers available, and these compounds are among the most commonly prescribed groups of drugs. The efficacy of beta blockers has been proven predominantly for the treatment of cardiovascular diseases. Beta blockers are also used for certain types of CNS disorders, such as anxiety disorders, essential tremor and migraine. While low toxicity means that they have a favorable risk-benefit ratio, given the high intensity of use, it is essential to have a comprehensive knowledge of adverse events. Adverse events of beta blockers that can be related to the CNS are quite often neglected, even in textbooks of clinical pharmacology or review articles, and thus often misdiagnosed. The following article, therefore, after summarizing the use of beta blockers for CNS indications, critically reviews the literature on centrally mediated adverse events. General pharmacological features of beta blockers and their molecular basis of action will briefly be addressed to the extent that they are or may become relevant for central nervous pharmacotherapy and side-effects.
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PMID:Adverse CNS-effects of beta-adrenoceptor blockers. 895 49


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