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Recent postmortem studies have found limited Lewy body pathology in some patients and Purkinje cell loss with torpedoes and Bergmann gliosis in others. These findings have led to the hypothesis that ET is a syndrome produced by at least two neurodegenerative diseases with more widespread clinical consequences than previously appreciated. We review the evidence for and against this hypothesis and conclude that studies purporting to support this hypothesis have failed to control for age\u2010associated comorbidities, depression, medications, and other confounding factors. We propose the alternative hypothesis that abnormal neuronal oscillation is the fundamental abnormality in ET, and the well\u2010documented cerebellar signs and symptoms, the controversial non\u2010motor signs, and even the cerebellar pathology of ET could be caused by this oscillation. A major problem for many studies is the lack of a diagnostic gold standard. Lacking such a standard, we propose a subclassification of ET into three categories: hereditary ET, sporadic ET, and senile ET, which we believe will help researchers resolve many of the controversies in this field. \u00a9 2009 Movement Disorder Society<\/jats:p>","DOI":"10.1002\/mds.22755","type":"journal-article","created":{"date-parts":[[2009,9,11]],"date-time":"2009-09-11T16:29:12Z","timestamp":1252686552000},"page":"2033-2041","source":"Crossref","is-referenced-by-count":190,"title":["Essential tremor \u2014 Neurodegenerative or nondegenerative disease towards a working definition of 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