Botulinum Toxin for Isolated or Essential Head Tremor

In a randomized trial, improvement was statistically better with active treatment than with placebo.

Limited data are available on the use of botulinum toxin to treat head tremor. In this multicenter, double-blind trial, adults with either isolated or essential head tremor, with or without associated limb tremor, were randomized 1:1 to receive botulinum toxin type A or placebo. The investigators used electromyographic guidance to inject 75 to 100 IU of toxin or placebo into each splenius capitis muscle. Patients with dystonia or ataxia were excluded. The decision on employing one or multiple injection sites was left to the neurologist's judgement. The primary outcome measure was improvement by at least 2 points on the Clinical Global Impression of Change (CGI) scale at week 6 after the second injection series (week 18 from baseline).

Among …

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)