ArticleTremor and other hyperkinetic movements (New York, N.Y.)2020
The Problem of Questionable Dystonia in the Diagnosis of 'Essential Tremor-Plus'.
Article in Tremor and other hyperkinetic movements (New York, N.Y.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed.
- Kinetic-rest tremor dominance for differentiating dystonic tremor from Parkinson's disease.Journal of Parkinson's disease · 2026Article
- Predictors of Incident Dementia in a Cohort of Elders with Essential Tremor: A Prospective, Longitudinal Study.Neuro-degenerative diseases · 2026Article
- Magnetic resonance-guided focused ultrasound thalamotomy in essential tremor subtypes: a phenotype-based insight into gait and balance.Brain communications · 2026Article
- Sleep Disturbances and Their Correlates in Essential Tremor and Essential Tremor Plus: A Questionnaire-Based Case-Control Study.Tremor and other hyperkinetic movements (New York, N.Y.) · 2026Article
- Unravelling head tremor mechanisms: insights from speech analysis in essential tremor and cervical dystonia.Journal of neural transmission (Vienna, Austria : 1996) · 2025Article
- Subtle bradykinesia features are easier to identify and more prevalent than questionable dystonia in essential tremor.Journal of neural transmission (Vienna, Austria : 1996) · 2025Article
- Polysomnographic Evaluation of Sleep Disorders in Essential Tremor and Essential Tremor Plus: A Comparison With Healthy Controls.Journal of movement disorders · 2025Article
- Clinical and kinematic characterization of parkinsonian soft signs in essential tremor.Journal of neural transmission (Vienna, Austria : 1996) · 2024Article
- Bedside clinical assessment of patients with common upper limb tremor and algorithmic approach.Asian biomedicine : research, reviews and news · 2024Review
- Six Myths and Misconceptions about Essential Tremor.Tremor and other hyperkinetic movements (New York, N.Y.) · 2024Review
- Exploring White Matter Microstructure with Symptom Severity and Outcomes Following Deep Brain Stimulation in Tremor Syndromes.Tremor and other hyperkinetic movements (New York, N.Y.) · 2024Article
- Longitudinal study of clinical and neurophysiological features in essential tremor.European journal of neurology · 2023Article
- Motor features associated with cognition in non-demented individuals with essential tremor.Journal of the neurological sciences · 2022Article
- The differences in clinical characteristics and natural history between essential tremor and essential tremor plus.Scientific reports · 2022Article
- Essential Tremor: Five New Things.Neurology. Clinical practice · 2022Article
- Bayesian Interpretation of Essential Tremor Plus.Journal of clinical neurology (Seoul, Korea) · 2022Review
- Cerebello-thalamic activity drives an abnormal motor network into dystonic tremor.NeuroImage. Clinical · 2022Article
- A standardized accelerometry method for characterizing tremor: Application and validation in an ageing population with postural and action tremor.Frontiers in neuroinformatics · 2022Article
- Essential Tremor versus "ET-plus": A Detailed Postmortem Study of Cerebellar Pathology.Cerebellum (London, England) · 2021Article
- Mixed Motor Disorder: Essential Tremor Families With Heterogeneous Motor Phenomenology.Neurology. Clinical practice · 2021Article
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Abstract
In a recent consensus statement on tremor, the task force of the International Parkinson and Movement Disorder Society proposed a new term, 'essential tremor-plus (ET-plus)' which includes patients with the characteristics of essential tremor (ET) and additional soft neurological signs of uncertain significance such as questionable dystonic posturing. The clinical interpretation of questionable dystonia has been left to the investigator. The consensus statement also stated that the ET-plus syndrome does not include other clearly defined syndromes like dystonic tremor. However, the boundary between questionable dystonia and definite dystonia is not distinct leading to diagnostic uncertainty in a clinical setting. A similar case may be classified as ET-plus by one observer and dystonic tremor by another. Following the new definition, many studies have reclassified their ET cohort, and they have highlighted the problem of defining questionable dystonia in the diagnosis of ET plus. ET-plus is likely to be a mixture of patients that actually have dystonia and those that don't, and clinically all we can do is to be suspicious that there might be dystonia. For example, it is not clear whether we should consider spooning and index finger pointing as a sign of questionable or definite dystonia. There are major research and possible therapeutic implications of questionable dystonia in the diagnosis of ET-plus. The concept of ET-plus is extremely difficult to implement without definite guidelines. The resolution will need a biomarker such as physiology or imaging.
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