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Updated: Sep 30, 2025

MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
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Problems and controversies in tremor classification.

Elan D Louis1, Peter G Bain2

  • 1Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Journal of the Neurological Sciences
|March 13, 2022
PubMed
Summary
This summary is machine-generated.

The 2018 tremor classification has issues with definitions and terminology, particularly for essential tremor (ET) and orthostatic tremor (OT). The authors propose redefining tremor and ET, emphasizing severity, and abandoning

Keywords:
Essential tremorEssential tremor plusInternal tremorOrthostatic tremorTremor classification

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Area of Science:

  • Neurology
  • Movement Disorders
  • Clinical Neuroscience

Background:

  • The International Parkinson and Movement Disorder Society (MDS) revised tremor classification in 2018.
  • This revision addressed essential tremor (ET), dystonia-associated tremor, and other tremor types.
  • The 1998 statement was the previous standard for tremor classification.

Purpose of the Study:

  • Critique the limitations of the 2018 MDS Consensus Statement on tremor classification.
  • Propose specific revisions to improve tremor diagnosis and categorization.
  • Enhance the understanding and clinical management of various tremor disorders.

Main Methods:

  • Critical analysis of the 2018 MDS Consensus Statement.
  • Review of existing literature on tremor classification and diagnosis.
  • Formulation of proposed changes to tremor terminology and diagnostic criteria.

Main Results:

  • Identified problems in the definition of tremor and essential tremor (ET).
  • Highlighted issues with proposed terms like 'essential tremor plus' and 'orthostatic tremor plus' (OT).
  • Noted the absence of a hierarchical structure for tremor classification.

Conclusions:

  • Recommended redefining tremor as a symptom and essential tremor (ET).
  • Advocated for incorporating severity as a key diagnostic characteristic.
  • Proposed abandoning non-hierarchical terms and establishing clear classification rules for tremors.