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Instituto Nacional de Neurología y Neurocirugía

2006, Número 3

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Arch Neurocien 2006; 11 (3)


Temblor esencial

Cruz EE, Otero SE

Idioma: Español
Referencias bibliográficas: 165
Paginas: 194-204
Archivo PDF: 168.53 Kb.


RESUMEN

Objetivo: el temblor esencial (TE) Es el más frecuente de todos los temblores, presente hasta el 22% de la población mayor a 65 años, con prevalencia 5 a 20 veces mayor a la enfermedad de Parkinson, puede causar discapacidad social, física, y psicológica. Por ello realizamos una búsqueda exhaustiva del estado actual de esta enfermedad. Tiene variabilidad racial, incidencia estimada en 18 por 100,000 habitantes, es autosómico dominante, con expresión variable, penetrancia reducida y etiología multifactorial, encontrándose herencia familiar del 50 al 60%. Puede presentar fenómeno de anticipación, para su diagnóstico deben excluirse causas identificables de temblor, puede ser postural y de acción en 49.4%, solo postural en 26.7%, solo de acción en 9.1%, con afección de manos en 94.9%, cabeza 26.5%, voz 16.99%, pierna 11.30%, lengua 3.78% tronco 1.88%, o labios, afectar la marcha en tandem y desencadenarse en movimientos específicos. Conclusión: consumiendo pequeñas dosis de alcohol el TE puede disminuir o desaparecer. Se ha atribuido a alteración en corteza motora, tálamo, cerebelo, médula espinal, núcleo rojo, núcleo olivar inferior y receptores â. Puede asociarse a alteración olfatoria, auditiva, de vías aéreas, musculatura respiratoria, migraña y vértigo. El diagnóstico se basa en las características clínicas, y ausencia de alteración extrapiramidal o cerebelosa. El tratamiento de elección comprende betabloqueantes, primidona y nicardipina. Las alternativas quirúrgicas son la estimulación del tálamo y la talamotomía.


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