Читать книгу Current Concepts in Movement Disorder Management - Группа авторов - Страница 72

Available results provide evidence of mild-to-moderate efficacy of low-dose BTXA injections in the forearm muscles of patients with upper extremity ET. Muscle weakness is observed in 30–70% of treated patients, but the exact impact of this adverse effect on patient global functioning needs to be investigated further. BTXA may reduce head and voice tremor associated with ET, but data are limited. BTXA injections for limb, head, and voice tremor associated with ET may be considered in medically refractory cases [18, 20].

Combination of first- and second-line therapies may bring additional benefits. Finally, stereotactic thalamic surgery should be considered in patients with significant disability related to ET, if the symptom is refractory or present a response that is not functionally significant.