Consensus Statement of the Movement Disorder Society on Tremor

Authors

  • Günther Deuschl MD,

    Corresponding author
    1. Neurologische Klinik der Christian-Albrechts-Universität zu Kiel, Kiel, Germany
    • Günther Deuschl, Neurologische Klinik der Christian-Albrechts-Universität zu Kiel, Niemannsweg 147, 24105 Kiel, Germany
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  • Peter Bain Ma, MD,Frcp,

    1. British Tremor Research Group Laboratory, Division of Neuroscience & Psychological Medicine, Charing Cross Hospital, Imperial College School of Medicine, London, England
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  • Mitchell Brin MD

    1. Movement Disorder Program, Mount Sinai Medical Center, New York, NY, U.S.A.
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  • Members of the Ad Hoc Scientific Committee: Yves Agid, France: Peter Bain. U.K.; Alim Louis Benabid, France; Reiner Benecke. Germany; Alfredo Berardelli, Italy; Mitchell Brin, U.S.A.; David J. Brooks, U.K.; Günther Deuschl, Germany; Rodger Elble, U.S.A.; Stan Fahn, U.S.A.; Leslie J. Findley, U.K.; Mark Hallett, U.S.A.; Joseph Jankovic, U.S.A.; William C. Koller, U.S.A.; Paul Krack, Germany: Anthony E. Lang, Canada; Andrew Lees, U.K.; Carl H. Lücking. Germany; C. David Marsden, U.K.; J.A. Obeso, Spain; Wolfgang H. Oertel, Germany; Werner Poewe, Austria; Pierre Pollak, France: Niall Quinn, U.K.; John C. Rothwell, U.K.; Hiroshi Shibasaki, Japan; Philip Thompson, Australia; and Eduardo Tolosa, Spain.

Abstract

This is a proposal of the Movement Disorder Society for a clinical classification of tremors. The classification is based on the distinction between rest, postural, simple kinetic, and intention tremor (tremor during target-directed movements). Additional data from a medical history and the results of a neurologic examination can be combined into one of the following clinical syndromes defined in this statement: enhanced physiologic tremor, classical essential tremor (ET), primary orthostatic tremor, task- and position-specific tremors, dystonic tremor, tremor in Parkinson's disease (PD), cerebellar tremor, Holmes' tremor, palatal tremor, drug-induced and toxic tremor, tremor in peripheral neuropathies, or psychogenic tremor. Conditions such as asterixis, epilepsia partialis continua, clonus, and rhythmic myoclonus can be misinterpreted as tremor. The features distinguishing these conditions from tremor are described. Controversial issues are outlined in a comment section for each item and thus reflect the open questions that at present cannot be answered on a scientific basis. We hope that this statement provides a basis for better communication among clinicians working in the field and stimulates tremor research.

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