Essential tremor is the most prevalent movement disorder, affecting up to 4% of the general population. Although the exact cause remains largely unknown, about half of all cases are familial, and transmission is most consistent with an autosomal dominant mechanism.
Essential tremor progresses slowly over time and can result in significant disability, affecting daily tasks and work responsibilities. As a result, patients often withdraw from social interactions and many develop depressive disorders.
Medical treatments such as beta-blockers and anticonvulsants are available to most patients, but an estimated 25%-30% of patients cannot tolerate medication or become refractory to recommended treatment doses. In such cases, neurosurgical options may be considered.
In this series, neuroscientists and surgeons from HM Puerta del Sur Hospital in Madrid, Spain, as well as Brigham and Women’s Hospital in Boston, Massachusetts, and the University of Florida, Gainesville, discuss the evolution of surgical interventions for essential tremor, spanning from the early era of frame-based stereotactic surgery to the current array of modern modalities, including deep brain stimulation and focused ultrasound. These advancements have significantly broadened the treatment options available to patients with essential tremor.