MD, Neurologists, MDS
The question often comes up in discussions of diagnosis of essential tremor as to what type of medical professional you need to be seen by: MD/DO, Neurologists, or MDS.
Your first step for diagnosis or treatment of Essential tremor is to consult with your Primary Care Physician (PCP). The amount of experience your PCP has with Essential Tremor, Parkinson’s or other movement disorders can vary. Personal experience has shown that PCPs are able to provide a preliminary diagnosis of ET and differentiate between ET and Parkinson’s. Your PCP can refer you to a neurologist.
A neurologist treats ailments of the nervous system. They deal with the diagnosis and treatment of diseases and conditions involving the brain, spinal cord, and nerves, and tissues that respond to nerve stimulation. A neurologist will review your medical history as it pertains to ET and clinically examine your tremor to determine if it is ET or some other movement disorder such as dystonia or Parkinson’s. Your neurologist may request additional tests to eliminate some of these alternatives, or they may refer you to a Movement Disorder Specialist (MDS).
A Movement Disorder Specialist (MDS) is a Neurologist who has, via a fellowship, studied Movement disorders such as ataxia, dystonia, essential tremor, Parkinson's disease and parkinsonism. These fellowships usually last 1 to 2 years, during which the physicians acquire in-depth knowledge of movement disorders – their symptoms, medications, and current research. Each teaching institution appears to follow their own curriculum and there are no credits awarded for this study.
An MDS would always be my first choice for anyone seeking care for their ET, but it may not be an option depending on where you live. I checked all of the web profiles of the neurologists for two of the largest medical providers in metropolitan Detroit: Michigan Medicine and Henry Ford. Result: 0 Movement Disorder Specialists, or at least no one who has added the MDS designation to their web profile.
In 2023 the Parkinson and Movement Disorder Society found that there are only 660 MDS physicians who practice in the U.S.[1] With only 88 fellowships for Movement Disorder Specialists, it's unlikely the number of MDS physicians will increase appreciably in the near future.[2]
Historically, Parkinson’s Disease has received a large measure of general neurologists’ attention, and Movement Disorder Specialists also appear to share this predisposition. This should not come as a surprise: essential tremor did not even have its own diagnostic code until 2013. It would appear from older research papers that essential tremor and Parkinson’s populations were grouped together without distinguishing qualifications. Parkinson’s research has benefited from the high visibility of Michael J. Fox and the MJF Foundation. Research on essential tremor would benefit from a similar high profile figurehead.
References:
1 Care access and utilization among medicare beneficiaries living with Parkinson’s disease (2023)
2 Viewpoint on Milestones for Fellowship Training in Movement Disorders (2022)
ETP: Essential Tremor Pearls are short, concise, easy to read and understand articles about all things related to Essential tremor.
Disclaimer: The information provided herein is for educational purposes only and is not intended to replace the advice of a physician or other qualified medical professional.
© 2024 James Kissel & Mark Honeyman
This work is licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by-nc-sa/4.0/
DOI 10.5281/zenodo.12575919
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