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      Essential tremor-plus: a controversial new concept

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          Abstract

          In addition to redefining essential tremor (ET), the 2018 consensus statement of the Movement Disorder Society on tremor coined a new term: essential tremor-plus (ET-plus). This term is uncertainly defined as tremor with the characteristics of ET, with additional neurological signs of uncertain clinical significance. If ET-plus had been defined on the basis of a difference in underlying pathology or an appreciable difference in prognosis, it would have a valid, scientific rationale, as does the term Parkinson-plus. However, there is no such evidence, so the basis for the term is questionable. In fact, ET-plus might only represent a state condition (ie, patients with ET might develop these additional clinical features when the disease is at a more advanced stage). We caution against coining new terms that are not supported by a firm scientific basis and encourage research into the creation of essential tremor subsets that are defined with respect to differences in underlying causes or pathophysiology.

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          Author and article information

          Journal
          The Lancet Neurology
          The Lancet Neurology
          Elsevier BV
          14744422
          November 2019
          November 2019
          Article
          10.1016/S1474-4422(19)30398-9
          31767343
          a0ee1c27-40f1-4a36-8dbd-f23026e48910
          © 2019

          https://www.elsevier.com/tdm/userlicense/1.0/

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