The primary type of tremor in essential tremor is kinetic rather than postural: cross-sectional observation of tremor phenomenology in 369 cases

Eur J Neurol. 2013 Apr;20(4):725-7. doi: 10.1111/j.1468-1331.2012.03855.x. Epub 2012 Aug 27.

Abstract

Background: Essential tremor (ET) is amongst the most commonly misdiagnosed neurological diseases. The current aim was to provide observational data on a basic characteristic of ET, namely, the relative severity of postural to kinetic tremor.

Methods: A total of 369 ET cases were enrolled in a cross-sectional study. Postural tremor scores (0-3) and kinetic tremor scores (0-3) were assigned during a standardized neurological examination.

Results: In the vast bulk of cases (~95%), kinetic tremor was more severe than postural tremor. In nearly one-in-three cases (32.8%), the kinetic tremor score was ≥ 1 points higher than the postural tremor score. Conversely, in only a few cases (~5%) was postural tremor even marginally (<1 point) more severe than kinetic tremor, and in no case was the postural tremor score ≥ 1 point higher than the kinetic tremor score. At each postural tremor score, nearly all cases had that amount of kinetic tremor or more.

Conclusion: The primary type of tremor in ET is kinetic rather than postural. Recognition of the simple, empirical features of tremor phenomenology has potential diagnostic value for practicing clinicians.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Arm / physiopathology
  • Cross-Sectional Studies
  • Diagnosis, Differential
  • Essential Tremor / diagnosis
  • Essential Tremor / epidemiology*
  • Essential Tremor / physiopathology*
  • Female
  • Humans
  • Kinetics
  • Male
  • Middle Aged
  • Movement*
  • Neurologic Examination
  • Posture*