What is “essential” about essential tremor? A diagnostic placeholder

Questionable Dystonia in Essential Tremor Plus: A Video‐Based Assessment of 19 Patients

“…The consensus definition further states that the ET plus syndrome does not include other defined syndromes such as dystonic tremor and task‐specific tremor. However, in a clinical setting interpretation of questionable dystonic posturing is subjective with a high rate of discordance and one of the major challenges is to differentiate ET plus from a dystonic tremor syndrome …”

Understanding the new tremor classification

“…After much discussion, we concluded that a broader definition would be confusing because studies are lacking that unequivocally extend the clinical phenomenology of ET. This may be different for the field of dystonia, as the viewpoint authors mention . Other symptoms and signs described in the literature in association with ET (eg, nondiagnostic cognitive disturbances, ataxia, or dystonia) are not generally accepted features of patients with ET, and the inclusion of these signs and symptoms in the definition of ET would result in an axis 1 syndrome that is too broad and heterogeneous to be clinically useful in finding specific etiologies.…”

“…The new consensus statement of the International Parkinson and Movement Disorder Society (IPMDS) task force on tremor came with an editorial by Albanese and a viewpoint from Fasano and colleagues, and we thank these authors for their comments. We particularly point to the scholarly ancient history of the term tremor in the editorial .…”

“…Some descriptions of the 1998 classification have been omitted or reworded, which the viewpoint seemingly misses. One specific example is the separation of the different subforms of tremor in Parkinson's disease (types I‐IV).…”

“…A similar issue is the classification of essential and symptomatic palatal tremors as 2 clinically distinct syndromes that can be defined unequivocally in axis 1 by means of simple clinical assessment. Renaming essential palatal tremor as “isolated palatal tremor” would accomplish little because the soft palate is not only involved in essential palatal tremor, and assigning this to a functional disorder based on recent papers would be premature given the possibility of other etiologies.…”