View/Open - Scholarly Commons Home

Chapter 2 – Literature Review
Louis, et al. (2006) examined 10 ET brains of which 6 had Lewy bodies.
Of these, 4 had a high density of Lewy bodies in the Locus Coeruleus.
The possible role Lewy bodies may have in ET is poorly understood.
Medical treatments
A number of medical options are utilised for the treatment of ET
including the use of certain medications and surgery. Though there is no
specific ET drug, two commonly prescribed medications are Propranolol
and Primidone (R. Elble, 2009). Propranolol is a beta-blocking agent,
designed primarily for cardiac and hypertensive conditions (Medsafe,
2010a). It has the ability to cross the blood brain barrier (Medsafe,
2010a), but may cause fatigue and depression amongst other side
effects (R. Elble, 2009). Primidone is an anti-convulsant, anti-epileptic
agent, reducing the central nervous system’s sensitivity to seizures
(Medsafe, 2010b). It too carries side effects such as nausea and
weakness (R. Elble, 2009). ET patients display a variable and sometimes
poor response to these two medications with initial effectiveness often
reported as low as 50%. Unfortunately in those that respond to the
medication, the magnitude of these benefits decreases over time (R.
Elble, 2009; Lyons, et al., 2006). An assessment of 223 ET patients by
Diaz and Louis (2010) reported that 70.9% of the ET patients had been
on either medication, of which 56.3% stopped taking them. Other
medications such as Atenolol and Gabapentin have also been used in ET
patients with similar limited success (Lyons & Pahwa, 2008).
20