Clinical spectrum and classification of non-parkinsonian tremors in rural India: Application of the 2017 MDS consensus criteria

Abstract BACKGROUND: Non-parkinsonian tremors (NPT) are a heterogeneous group of tremor disorders, with essential tremor (ET) being the most common type. The revised 2017 Movement Disorder Society (MDS) classification system has provided a new framework for categorizing these disorders. OBJECTIVES: The study aims to assess the prevalence, clinical characteristics, and severity of NPT in a tertiary care hospital in western India using the 2017 MDS classification. MATERIALS AND METHODS: This cross-sectional study enrolled 202 patients aged ≥18 years with NPT who attended the neurology outpatient clinic at a rural tertiary care hospital in Gujarat, India, over 14 months. Evaluation included the 2017 MDS Consensus Classification system for tremors and the Fahn–Tolosa–Marin Tremor Rating Scale (FTM-TRS) for assessing tremor severity. RESULTS: The prevalence of NPT was 2.34% in neurology outpatient clinics and 28.25% in the movement disorder clinic. Idiopathic tremor disorders were the most prevalent sub-type (71.28%), followed by acquired tremor disorders (26.7%) and genetically determined syndromes (1.98%). ET, ET-plus, and dystonic tremors had similar prevalence rates. Significant differences were observed in age of onset, gender distribution, family history, and tremor severity among the tremor sub-types. CONCLUSION: This study highlights the diverse spectrum of NPT and underscores the importance of tailored diagnostic and management approaches to improve patient outcomes in the Indian context.