Evidence map›Paper›PMID 32457087›Full record

ReviewJournal of neurology, neurosurgery, and psychiatry2020

Systematic clinical approach for diagnosing upper limb tremor.

Jaron van de Wardt, A M Madelein van der Stouwe, Michiel Dirkx, Jan Willem J Elting, Bart Post, Marina Aj Tijssen, Rick C Helmich

Open access · hybridAbstract readReview
In one paragraph

Review in Journal of neurology, neurosurgery, and psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 1 pooled it
3.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.

  1. Pooled it
  2. Essential Tremor Suppression with a Novel Anti-Tremor Orthosis: A Randomized Crossover Trial.Movement disorders : official journal of the Movement Disorder Society · 2025
    Trial
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  11. Review
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  17. Tips and tricks in tremor treatment.Journal of neural transmission (Vienna, Austria : 1996) · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Jaron van de WardtDepartment of Neurology, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands.
A M Madelein van der StouweDepartment of Neurology, University Medical Centre Groningen (UMCG), Groningen, The Netherlands a.m.m.van.der.stouwe@umcg.nl.ORCID 0000-0001-9497-2019
Michiel DirkxDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Jan Willem J EltingDepartment of Neurology, University Medical Centre Groningen (UMCG), Groningen, The Netherlands.
Bart PostDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
Marina Aj TijssenDepartment of Neurology, University Medical Centre Groningen (UMCG), Groningen, The Netherlands.ORCID 0000-0001-5783-571X
Rick C HelmichDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.ORCID 0000-0003-4035-6573
Radboud University Nijmegen · NLUniversity Medical Center Groningen · NLCanisius-Wilhelmina Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Tremor is the most common movement disorder worldwide, but diagnosis is challenging. In 2018, the task force on tremor of the International Parkinson and Movement Disorder Society published a consensus statement that proposes a tremor classification along two independent axes: a clinical tremor syndrome and its underlying aetiology. In line with this statement, we here propose a stepwise diagnostic approach that leads to the correct clinical and aetiological classification of upper limb tremor. We also describe the typical clinical signs of each clinical tremor syndrome. A key feature of our algorithm is the distinction between isolated and combined tremor syndromes, in which tremor is accompanied by bradykinesia, cerebellar signs, dystonia, peripheral neuropathy or brainstem signs. This distinction subsequently informs the selection of appropriate diagnostic tests, such as neurophysiology, laboratory testing, structural and dopaminergic imaging and genetic testing. We highlight treatable metabolic causes of tremor, as well as drugs and toxins that can provoke tremor. The stepwise approach facilitates appropriate diagnostic testing and avoids unnecessary investigations. We expect that the approach offered in this article will reduce diagnostic uncertainty and increase the diagnostic yield in patients with tremor.

Indexed as

ArmDiagnosis, DifferentialHumansMyographyTremordystoniamyoclonusneurophysiol, clinicalparkinson's diseasetremor

Identifiers

PMID32457087
PMCPMC7402459
OpenAlexW3030698703

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.