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Clinical characteristics of essential tremor: data from a community-based study
1Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Summary
Essential tremor (ET) is often mild and asymptomatic in the community, with kinetic tremor being more severe than postural tremor. Most individuals with ET do not seek medical attention or receive treatment.
Area of Science:
- Neurology
- Movement Disorders
- Clinical Research
Background:
- Essential tremor (ET) is highly prevalent in the community, yet clinic-based studies do not capture its full clinical spectrum.
- Most individuals with ET experience mild tremor and do not seek clinical evaluation.
- Previous community-based studies have primarily focused on ET prevalence, not its clinical characteristics.
Purpose of the Study:
- To characterize the clinical presentation of essential tremor (ET) within a community-based sample.
- To provide a comprehensive description of ET beyond what is observed in clinical settings.
Main Methods:
- A community-based study in Washington Heights-Inwood, New York, identified 73 subjects with ET.
- Participants underwent a standardized tremor interview and videotaped examination with 12 bedside tests.
- Movement disorder specialists rated tremor severity and assigned ET diagnoses with high interrater reliability.
Main Results:
- Diagnoses included definite (24.7%), probable (43.8%), and possible (31.5%) ET.
- Nearly half (49.3%) of subjects were asymptomatic, and 91.8% were untreated.
- Kinetic tremor was consistently more severe than postural tremor (98.6% of cases).
Conclusions:
- This study presents clinical findings from a largely untreated, community-based ET cohort.
- The tremor in this cohort was mild, often asymptomatic, and not always present during examination.
- Kinetic tremor severity exceeding postural tremor severity is a key characteristic of ET.