title: The primary type of tremor in essential tremor is kinetic rather than postural: cross-sectional observation of tremor phenomenology in 369 cases.
abstract: BACKGROUND
  Essential tremor (ET) is amongst the most commonly misdiagnosed neurological diseases. The current aim was to provide observational data on a basic characteristic of ET, namely, the relative severity of postural to kinetic tremor.
  
  
  METHODS
  A total of 369 ET cases were enrolled in a cross-sectional study. Postural tremor scores (0-3) and kinetic tremor scores (0-3) were assigned during a standardized neurological examination.
  
  
  RESULTS
  In the vast bulk of cases (~95%), kinetic tremor was more severe than postural tremor. In nearly one-in-three cases (32.8%), the kinetic tremor score was ≥ 1 points higher than the postural tremor score. Conversely, in only a few cases (~5%) was postural tremor even marginally (<1 point) more severe than kinetic tremor, and in no case was the postural tremor score ≥ 1 point higher than the kinetic tremor score. At each postural tremor score, nearly all cases had that amount of kinetic tremor or more.
  
  
  CONCLUSIONS
  The primary type of tremor in ET is kinetic rather than postural. Recognition of the simple, empirical features of tremor phenomenology has potential diagnostic value for practicing clinicians.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. EDL2@columbia.edu
authors.forename: E D
authors.initials: ED
authors.lastname: Louis
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D001132:Arm / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D020329:Essential Tremor / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009068:Movement; D009460:Neurologic Examination; D011187:Posture