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Remarkable improvement of primary orthostatic tremor using perampanel

Management of primary orthostatic tremor (POT) remains challenging, and medication is often ineffective. We report the case of a 53-year-old female with orthostatic tremor for 6 years who was refractory to gabapentin, clonazepam, primidone and propranolol. After treatment with 4 mg/day perampanel, s...

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Autores principales: Grobe-Einsler, Marcus, Kaut, Oliver
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650059/
https://www.ncbi.nlm.nih.gov/pubmed/33324909
http://dx.doi.org/10.1186/s42466-020-0050-0
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author Grobe-Einsler, Marcus
Kaut, Oliver
author_facet Grobe-Einsler, Marcus
Kaut, Oliver
author_sort Grobe-Einsler, Marcus
collection PubMed
description Management of primary orthostatic tremor (POT) remains challenging, and medication is often ineffective. We report the case of a 53-year-old female with orthostatic tremor for 6 years who was refractory to gabapentin, clonazepam, primidone and propranolol. After treatment with 4 mg/day perampanel, she reported almost complete resolution of tremor. The diagnosis of POT was confirmed by tremor analysis using surface electromyography. Our report shows the potential use of the novel AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptor antagonist perampanel for the treatment of POT. To date, only two similar patients, one refractory to treatment and the other previously treated with clonazepam only, have been reported. We would like to note that our patient was refractory to all previous therapy and responded to a low dose of perampanel without side effects. The striking clinical improvement suggests a putative role of glutamate in the pathophysiology of orthostatic tremor.
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spelling pubmed-76500592020-12-14 Remarkable improvement of primary orthostatic tremor using perampanel Grobe-Einsler, Marcus Kaut, Oliver Neurol Res Pract Letter to the Editor Management of primary orthostatic tremor (POT) remains challenging, and medication is often ineffective. We report the case of a 53-year-old female with orthostatic tremor for 6 years who was refractory to gabapentin, clonazepam, primidone and propranolol. After treatment with 4 mg/day perampanel, she reported almost complete resolution of tremor. The diagnosis of POT was confirmed by tremor analysis using surface electromyography. Our report shows the potential use of the novel AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid) receptor antagonist perampanel for the treatment of POT. To date, only two similar patients, one refractory to treatment and the other previously treated with clonazepam only, have been reported. We would like to note that our patient was refractory to all previous therapy and responded to a low dose of perampanel without side effects. The striking clinical improvement suggests a putative role of glutamate in the pathophysiology of orthostatic tremor. BioMed Central 2020-01-29 /pmc/articles/PMC7650059/ /pubmed/33324909 http://dx.doi.org/10.1186/s42466-020-0050-0 Text en © The Author(s) 2020 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Letter to the Editor
Grobe-Einsler, Marcus
Kaut, Oliver
Remarkable improvement of primary orthostatic tremor using perampanel
title Remarkable improvement of primary orthostatic tremor using perampanel
title_full Remarkable improvement of primary orthostatic tremor using perampanel
title_fullStr Remarkable improvement of primary orthostatic tremor using perampanel
title_full_unstemmed Remarkable improvement of primary orthostatic tremor using perampanel
title_short Remarkable improvement of primary orthostatic tremor using perampanel
title_sort remarkable improvement of primary orthostatic tremor using perampanel
topic Letter to the Editor
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650059/
https://www.ncbi.nlm.nih.gov/pubmed/33324909
http://dx.doi.org/10.1186/s42466-020-0050-0
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