標準的な内科治療でなかなか改善しない本態性振戦—外科治療が行えない場合

Essential Tremor That is Difficult to Improve with Standard Medical Treatment-Suppression: Excluding Surgical Treatment

標準的な内科治療でなかなか改善しない本態性振戦では，日常生活に支障がある場合は外科治療が考慮されるが，外科治療が行えない症例も存在する。本論では，標準的な内科治療とは何かを解説し，外科治療が行えない場合について考察した。内服治療はまずアロチノロールとプリミドンが基本であり，併用療法や第二選択薬の解説も行い，最後にわが国における本態性振戦治療アルゴリズムの作成を試みた。

Abstract

For essential tremors that are refractory to standard medical treatment, surgical treatment is considered when there is obstruction in activities of daily living. However, there are patients who do not wish to undergo or are contraindicated for surgical treatment. In this paper, we explored what is considered to be the standard medical treatment and when surgery cannot be performed. In Japan, medical treatment is based on the use of arotinolol and primidone, and combination therapy and second-line drugs are extensively discussed. Furthermore, an algorithm of the treatment for essential tremors in Japan has been provided.