Treatment of Wilson's Disease Presenting with Tremor

Wilson's disease can manifest with neurological features, among which tremor is a recognised and clinically significant symptom. When action or postural tremor is prominent, targeted pharmacological management is indicated alongside the underlying disease treatment.

Clinical scenario

Patient with Wilson's disease presenting with tremor — specifically action or postural tremor requiring pharmacological intervention to achieve symptom relief and functional improvement.

Treatment approach (overview)

First-line management for action/postural tremor in this setting involves specific pharmacological agents. Propranolol is among the options considered in current evidence-based guidance.

Full dosing, sequencing, and alternatives are detailed in the complete protocol →

Treatment goal: Relief or meaningful reduction of tremor symptoms.

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References

DOI: 10.1016/j.jhep.2024.11.007

In cases of action/postural tremor, the most effective pharmacological treatment option is propranolol (20–240 mg/day, divided into two or three doses), followed by primidone (25 mg/day up to 750 mg daily in three divided doses).

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