Abstract
Tremor is the most commonly encountered movement disorder in clinical practice. A wide range of pathologies may manifest with tremor either as a presenting or predominant symptom. Considering the marked etiological and phenomenological heterogeneity, it would be desirable to develop a classification of tremors that reflects their underlying pathophysiology. The tremor task force of the International Parkinson Disease and Movement Disorders Society has worked toward this goal and proposed a new classification system. This system has remained a prime topic of scientific communications on tremor in recent times. The new classification is based on two axes: 1. based on the clinical features, history, and tremor characteristics and 2. based on the etiology of tremor. In this article, we discuss the key aspects of the new classification, review various tremor syndromes, highlight some of the controversies in the field of tremor, and share the potential future perspectives.
Highlights
Tremor is an involuntary, rhythmic, and oscillatory movement which may involve one or several body parts [1, 2]
A broad search strategy was used with several keywords and combinations related to tremor
essential tremor (ET) is defined as an isolated tremor syndrome manifesting as an action tremor of bilateral upper extremities for a minimum of 3 years duration, in the absence of any other neurological signs such as parkinsonism, ataxia, or dystonia [1]
Summary
Rhythmic, and oscillatory movement which may involve one or several body parts [1, 2]. After leg stereotypy syndrome [3], tremor is the most commonly observed movement disorder in adults [4, 5]. The task force on tremor of the International Parkinson and Movement Disorders Society (IPMDS) proposed a classification scheme based on two axes; axis 1- emphasizing the clinical features, history, and tremor characteristics and axis 2- emphasizing the potential etiologies of tremor [1]. Since tremor has a vastly heterogeneous etiological spectrum, it is important to fully appreciate the phenomenology of tremor in various tremor syndromes and other neurological features associated with those syndromes. The major objective of this article is to provide an updated review of various tremor syndromes with special reference to the new bi-axial classification system. We highlight some of the controversies in the field of tremor, and share our perspectives for the future research
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