Essential tremor plus – a syndrome with greater cerebellar involvement?
Authors:
P. Hollý 1; T. Hubená 2; R. Krupička 2; ; E. Růžička 1
Authors‘ workplace:
Neurologická klinika a Centrum, klinických neurověd, 1. LF UK a VFN v Praze
1; Katedra biomedicínské informatiky, Fakulta biomedicínského inženýrství, ČVUT v Praze, Kladno
2
Published in:
Cesk Slov Neurol N 2025; 88(1): 47-52
Category:
Original Paper
doi:
https://doi.org/10.48095/cccsnn202547
Overview
Introduction: Essential tremor (ET) is characterized by isolated action tremor of the upper limbs, with or without tremor of the head, voice, or lower limbs. The newly defined ET plus (ET+) syndrome is characterized by the presence of additional mild neurological symptoms that are not indicative of other disease. Aim: This study investigated the incidence of ET+ in our patients to better understand the pathophysiological basis of both entities, with a special focus on cerebellar involvement. Methods: In a cohort of 51 patients with ET (27 women, mean age 67.5 ± 13.1 years), we verified anamnestic data and neurological findings. Tremor severity and the degree of disability in activities of daily living were assessed using The Essential Tremor Rating Assessment Scale (TETRAS), while symptoms of cerebellar involvement used the Scale for the Assessment and Rating of Ataxia (SARA). Results: ET+ was identified in 22 patients (mostly due to resting hand tremor), while 29 patients had “pure” ET. The two groups did not differ in age of onset or symptom duration. Patients with ET+ had a higher incidence of head tremor compared to those with ET (81 vs. 43%; P < 0.05) and higher scores on both the TETRAS and SARA scales (all P < 0.01). Conclusion: ET+ patients exhibited more severe overall tremor disability, a higher incidence of head tremor, and more pronounced signs of ataxia compared to patients with “pure” ET. Cerebellar involvement appears to play a significant role in additional manifestations of disability that characterize ET+ syndrome.
Keywords:
essential tremor – Cerebellum – head tremor – essential tremor plus – resting hand tremor
Sources
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