Department of Neurology, College of Physicians and Surgeons, Columbia University, 710 West 168th Street, New York, NY 10032, USA.
Parkinsonism Relat Disord. 2011 Aug;17(7):516-20. doi: 10.1016/j.parkreldis.2011.03.012. Epub 2011 Apr 12.
In recent years, studies of essential tremor (ET) have demonstrated that the disease is associated with functionally-relevant cognitive abnormalities, a mood disturbance and other psychiatric co-morbidities, a functionally significant gait disorder, hearing deficits, and a variety of types of tremor. The tremor has been shown to be progressive in nature and quite disabling for a large number of sufferers. Also, recent clinical-epidemiological studies have linked prevalent ET to other neurodegenerative diseases and at least one study has demonstrated an increased risk of mortality in an ET cohort. While many of these studies are derived from clinic-based samples, population-based studies have also substantiated these findings, suggesting that even in the general population, the disease is associated with disability and with co-morbidity. Based on these available studies, it would seem inaccurate to append the word "benign" to ET. Not unlike the word "essential" itself, the word "benign" is an antiquated and outdated term that reflects an era where little was understood about ET. Historically, the general doctors who frequently encountered the disorder would educate patients that it was a benign, non-progressive condition not associated with any co-morbidity or risk of long-term worry. This notion, conceived by prior generations of physicians, is now known to be inaccurate. It is therefore our recommendation that the medical community open the dialog to consider formally discontinuing this nosology ("benign essential tremor") and to adopt the use of the term "essential tremor." Use of the word "benign" is a mischaracterization of the disease course, and could be prove misleading especially in the evolving doctor-patient relationship. In those cases with currently-mild tremor, the nosology "mild essential tremor" would be a more accurate reflection of disease.
近年来，对特发性震颤（essential tremor，ET）的研究表明，该疾病与功能相关的认知异常、情绪障碍和其他精神共病、功能显著的步态障碍、听力缺陷以及各种类型的震颤有关。震颤已被证明具有进行性，对大量患者造成严重影响。此外，最近的临床流行病学研究将常见的 ET 与其他神经退行性疾病联系起来，至少有一项研究表明 ET 患者的死亡率增加。虽然这些研究大多来自临床样本，但基于人群的研究也证实了这些发现，表明即使在普通人群中，该疾病也与残疾和共病有关。基于这些现有研究，将“良性”一词附加到 ET 上似乎不准确。与“essential”一词一样，“benign”一词是一个过时的术语，反映了对 ET 知之甚少的时代。历史上，经常遇到这种疾病的全科医生会教育患者，这种疾病是良性的、非进行性的，不会引起任何共病或长期担忧。这一概念是由前几代医生提出的，现在已经被证明是不准确的。因此，我们建议医学界开启对话，考虑正式停止这种分类法（“良性特发性震颤”），并采用“特发性震颤”一词。使用“良性”一词是对疾病过程的错误描述，并且可能会产生误导，尤其是在不断发展的医患关系中。在那些目前震颤较轻的病例中，“轻度特发性震颤”的分类法将更准确地反映疾病。
