{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:09:37Z","timestamp":1769008177633,"version":"3.49.0"},"reference-count":93,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Neurol"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The approach and diagnosis of patients with tremor may be challenging for clinicians. According to the most recent consensus statement by the Task Force on Tremor of the International Parkinson Movement Disorder Society, the differentiation between action (i.e., kinetic, postural, intention), resting, and other task- and position-specific tremors is crucial to this goal. In addition, patients with tremor must be carefully examined for other relevant features, including the topography of the tremor, since it can involve different body areas and possibly associate with neurological signs of uncertain significance. Following the characterization of major clinical features, it may be useful to define, whenever possible, a particular tremor syndrome and to narrow down the spectrum of possible etiologies. First, it is important to distinguish between physiological and pathological tremor, and, in the latter case, to differentiate between the underlying pathological conditions. A correct approach to tremor is particularly relevant for appropriate referral, counseling, prognosis definition, and therapeutic management of patients. The purpose of this review is to outline the possible diagnostic uncertainties that may be encountered in clinical practice in the approach to patients with tremor. In addition to an emphasis on a clinical approach, this review discusses the important ancillary role of neurophysiology and innovative technologies, neuroimaging, and genetics in the diagnostic process.<\/jats:p>","DOI":"10.1055\/s-0043-1763508","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:06:03Z","timestamp":1678752363000},"page":"156-165","source":"Crossref","is-referenced-by-count":8,"title":["Diagnostic Uncertainties in Tremor"],"prefix":"10.1055","volume":"43","author":[{"given":"Luca","family":"Marsili","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Bologna","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy"},{"name":"IRCCS Neuromed, Pozzilli, Isernia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-6672","authenticated-orcid":false,"given":"Abhimanyu","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Rush Parkinson's Disease and Movement Disorders Program, Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/mds.27121","article-title":"Consensus Statement on the classification of tremors. from the task force on tremor of the International Parkinson and Movement Disorder Society","volume":"33","author":"K P Bhatia","year":"2018","journal-title":"Mov Disord"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1002\/mdc3.12498","article-title":"Positional tremor and its treatment","volume":"4","author":"S M Schaefer","year":"2017","journal-title":"Mov Disord Clin Pract (Hoboken)"},{"issue":"S 03","key":"ref3","first-page":"2","article-title":"Consensus statement of the Movement Disorder Society on tremor","volume":"13","author":"G Deuschl","year":"1998","journal-title":"Mov Disord"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1002\/mds.870120621","article-title":"Agreement among movement disorder specialists on the clinical diagnosis of essential tremor","volume":"12","author":"S Chouinard","year":"1997","journal-title":"Mov Disord"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.clinph.2022.01.004","article-title":"The clinical and electrophysiological investigation of tremor","volume":"136","author":"G Deuschl","year":"2022","journal-title":"Clin Neurophysiol"},{"issue":"19","key":"ref6","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1056\/NEJMcp1707928","article-title":"Essential tremor","volume":"378","author":"D Haubenberger","year":"2018","journal-title":"N Engl J Med"},{"issue":"06","key":"ref7","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.parkreldis.2006.12.004","article-title":"Essential tremor: phenotypic expression in a clinical cohort","volume":"13","author":"N R Whaley","year":"2007","journal-title":"Parkinsonism Relat Disord"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"821189","DOI":"10.3389\/fneur.2022.821189","article-title":"Uncovering essential tremor genetics: the promise of long-read sequencing","volume":"13","author":"L Marsili","year":"2022","journal-title":"Front Neurol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/mds.870130105","article-title":"How common is the most common adult movement disorder? estimates of the prevalence of essential tremor throughout the world","volume":"13","author":"E D Louis","year":"1998","journal-title":"Mov Disord"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1159\/000111584","article-title":"Does age of onset in essential tremor have a bimodal distribution? 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