Problems and controversies in tremor classification

Elan D. Louis, Peter G. Bain

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


The Consensus Statement on the Classification of Tremors, from the Task Force of the International Parkinson's and Movement Disorder Society was published in 2018 in response to advances in the understanding of essential tremor (ET), tremor associated with dystonia and other monosymptomatic and indeterminate tremors. This was a revision of the previous 1998 Consensus Statement. A number of problems arise from this classification and, in this manuscript, we highlight several of these. These problems relate to the definition of tremor, the definition of ET, the proposal of the term ‘essential tremor plus’, issues related to orthostatic tremor (OT) including the proposal of the term ‘orthostatic tremor plus’, and the absence of a hierarchy of terms used to classify tremor. Among the proposals we make is that the definition of tremor should acknowledge that tremor is a symptom, ET should be redefined, severity is an important characteristic for classifying and diagnosing tremor, the terms ‘essential tremor plus’ and ‘orthostatic tremor plus’ should be abandoned, and classification of tremor requires rules for creating a hierarchy of terminology. "This article is part of the Special Issue ""Tremor"" edited by Daniel D. Truong, Mark Hallett, and Aasef Shaikh".

Original languageEnglish (US)
Article number120204
JournalJournal of the Neurological Sciences
StatePublished - Apr 15 2022


  • Essential tremor
  • Essential tremor plus
  • Internal tremor
  • Orthostatic tremor
  • Tremor classification

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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