# Prevalence estimation of essential tremor in Hungary between 2010 and 2020 based on the National Health Insurance Fund Database

## TL;DR

This study estimates the prevalence of essential tremor in Hungary from 2010 to 2020 and examines treatment patterns.

## Contribution

The study provides the first prevalence estimate of essential tremor in Hungary using national health insurance data.

## Key findings

- The estimated age-standardized prevalence of essential tremor in Hungary is 378–388 per 100,000.
- 36.4% of patients with tremor did not receive any medication during the study period.
- Alprazolam and propranolol were the most commonly used medications, often in combination.

## Abstract

The published prevalence of essential tremor is variable worldwide and lacking in Central Europe. We aimed to estimate its prevalence in Hungary and to explore the locally applied therapeutic approaches. We collected data from the National Health Insurance Fund database and pharmacy database registered between 2010 and 2020. Matching the specified codes of the International Classification of Diseases and the individually tailored combination of interventions, we attempted to exclude Parkinson’s disease and other tremor evoking conditions. We estimated the period prevalence of essential tremor age standardized to the European Standard Population at 378–388/100,000. After excluding patients with possible Parkinsonian syndromes, we found that 36.4% of patients with tremor did not take any medication during the study period. Most of the rest used alprazolam followed by propranolol for the longest period of time; the alprazolam and propranolol combination was the most preferred. Deep brain stimulation and ablative surgery were chosen for less than 0.5% of the patients. Our strict methods probably underestimate the essential tremor prevalence in Hungary, which, however, does not differ considerably from international results. Given the limitations of medication therapy, expanding and improving neurosurgical interventions may help improve the quality of life of patients with essential tremor.