• Elan D Louis, Martin Bares, Julian Benito-Leon, Stanley Fahn, Steven J Frucht, Joseph Jankovic, William G Ondo, Pramod K Pal, and Eng-King Tan.
• Department of Neurology and Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA; Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA. Electronic address: elan.louis@yale.edu.
• Lancet Neurol. 2020 Mar 1; 19 (3): 266270266-270.

AbstractIn addition to redefining essential tremor (ET), the 2018 consensus statement of the Movement Disorder Society on tremor coined a new term: essential tremor-plus (ET-plus). This term is uncertainly defined as tremor with the characteristics of ET, with additional neurological signs of uncertain clinical significance. If ET-plus had been defined on the basis of a difference in underlying pathology or an appreciable difference in prognosis, it would have a valid, scientific rationale, as does the term Parkinson-plus. However, there is no such evidence, so the basis for the term is questionable. In fact, ET-plus might only represent a state condition (ie, patients with ET might develop these additional clinical features when the disease is at a more advanced stage). We caution against coining new terms that are not supported by a firm scientific basis and encourage research into the creation of essential tremor subsets that are defined with respect to differences in underlying causes or pathophysiology.Copyright © 2020 Elsevier Ltd. All rights reserved.

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