Fast orthostatic tremor in Parkinson's disease mimicking primary orthostatic tremor

  title={Fast orthostatic tremor in Parkinson's disease mimicking primary orthostatic tremor},
  author={Emmanuelle Apartis and Francois Tison and Pierre Arn{\'e} and C. Pierre Jedynak and Marie Vidailhet},
  journal={Movement Disorders},
Leg tremor during standing is a rare feature in idiopathic Parkinson's disease (PD). Tremor during standing usually has a low frequency (range, 4–6 Hz), similar to PD rest tremor frequency, and is improved by levodopa. We describe three cases of fast orthostatic tremor (FoT) of legs and trunk mimicking primary orthostatic tremor (OT) in patients treated with levodopa for PD. Asymmetrical akinetorigid syndrome was accompanied by a rest tremor in two cases. We obtained electrophysiological… 

Unilateral Pseudo-Orthostatic Tremor Provoked by a Remote Limb Movement in Parkinson’s Disease

A rare case of PD is reported in a patient whose disease initiated with a unilateral OT that had overlapping features of pseudo-OT and parkinsonism, which is rarely observed in association with PD.

Orthostatic tremor - a review.

Myoclonus or tremor in orthostatism: An under‐recognized cause of unsteadiness in Parkinson's disease

Observations show the usefulness of neurophysiological investigations for diagnosing and treating unexplained unsteadiness in Parkinson's disease, and patients with slow tremor and myoclonus improved on levodopa and sometimes benefited further when clonazepam was added.

Unilateral Standing Leg Tremor as the Initial Manifestation of Parkinson Disease

It appears that progression might be slow if PD patients have standing leg tremor as the initial manifestation, and one form is high frequency, similar to the primary orthostatic tremor and the other is low frequency andSimilar to the parkinsonian resting tremor.

[Orthostatic tremor causing postural instability in Parkinson disease: report of one case].

A 67-year-old female with orthostatic tremor who was treated with increasing doses of clonazepam, reaching 2 mg/day, and levodopa showed an improvement of postural instability with a good response of parkinsonian symptoms.

Primary orthostatic tremor is an exaggeration of a physiological response to instability

EMG data indicate the existence of a physiological system involved in organising postural responses under circumstances of imbalance and characterised by a highly synchronised output at approximately 16 Hz, and suggest that the core abnormality in POT may be an exaggerated sense of unsteadiness when standing still, which then elicits activity from a 16‐Hz oscillator normally engaged in postural responding.

Dopa Responsive Slow Orthostatic Tremor in Parkinson’s Disease

A Parkinson's disease patient with levodopa responsive slow OT showed abnormal movements of more regular rhythms and stable frequency on both legs on standing and these symptoms were aggravated at off state and improved by increasinglevodopa.

Orthostatic tremor: a review of 45 cases.

Dopaminergic deficit is not the rule in orthostatic tremor

A new role may emerge for 123I‐FP‐CIT SPECT in distinguishing between patients whose symptoms will be restricted to OT throughout the disease course and patients at an increased risk of developing PD.



Levodopa may improve orthostatic tremor: case report and trial of treatment

This study is the first trial of therapy in primary orthostatic tremor and suggests that levodopa can lead to good symptomatic relief in this potentially disabling condition.

A positron emission tomography study of primary orthostatic tremor

The abnormal pattern of cerebral activation associated with the postural upper limb tremor in four patients with primary OT was used to conclude that abnormal bilateral overactivity of cerebellar connections is a common feature of tremulous disorders.

Consensus Statement of the Movement Disorder Society on Tremor

  • G. DeuschlP. BainM. Brin
  • Medicine, Psychology
    Movement disorders : official journal of the Movement Disorder Society
  • 1998
This is a proposal of the Movement Disorder Society for a clinical classification of tremors based on the distinction between rest, postural, simple kinetic, and intention tremor (tremor during target‐directed movements).

Diagnostic and pathophysiological aspects of psychogenic tremors

It is concluded that psychogenic tremor can be positively diagnosed by means of neurologic signs in the majority of patients and is not only a diagnosis of exclusion.

Modulation of primary orthostatic tremor by magnetic stimulation over the motor cortex

The results suggest that a central oscillator, involving the motor cortex, has a crucial role in either the generation or modulation of orthostatic tremor.

Involvement of cranial muscles and high intermuscular coherence in orthostatic tremor

The high intermuscular coherence between all muscles indicates the existence of either a unique oscillator that generates tremor in all involved muscles on both sides of the body or a linking mechanism probably at a supraspinal level.

The physiology of orthostatic tremor.

It is suggested that orthostatic tremor may be generated by spontaneous oscillation in those central structures responsible for organizing the motor programs for standing.

Pramipexole is a possible effective treatment for primary orthostatic tremor (shaky leg syndrome).

Pramipexole is a potential therapy for primary orthostatic tremor and the patient had relief from his symptoms for the first time in 6 years.

Leg tremor mimicking orthostatic tremor as an initial manifestation of parkinson's disease