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Diagnostic criteria for essential tremor: a population perspective
1Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Archives of Neurology
|June 17, 1998
Summary
Diagnostic criteria significantly impact essential tremor (ET) diagnosis. Studies should prioritize tremor type and severity over family history for accurate population-based ET research.
Area of Science:
- Neurology
- Epidemiology
- Clinical Diagnostics
Background:
- Essential tremor (ET) prevalence estimates vary widely across studies.
- The influence of diagnostic criteria on ET research findings is unclear.
Purpose of the Study:
- To evaluate how different diagnostic criteria affect essential tremor (ET) diagnosis.
Main Methods:
- Applied 10 different published ET diagnostic criteria sets to a population-based cohort (WHIGET study).
- Cohort included 36 definite/probable ET cases, 34 possible ET cases, and 215 controls.
- Assessed diagnostic impact based on criteria for tremor distribution, duration, and severity.
Main Results:
- The proportion of ET cases diagnosed varied from 14% to over 100% depending on criteria used.
- Criteria emphasizing family history or long tremor duration excluded many true ET cases.
- Criteria lacking severity specifications included many non-ET individuals.
Conclusions:
- Diagnostic criteria substantially alter ET diagnosis rates in population studies.
- Future ET research should focus on tremor characteristics (type, severity) rather than family history.