Clinical and neurophysiologic spectrum of orthostatic tremor: Case series of 26 subjects

Abstract

Orthostatic tremor (OT) is a condition described as high-frequency tremors predominantly in the legs and trunk, which are present not only in the standing position but also during isometric contraction of the limb muscles. This report is one of the largest OT series describing clinical and neurophysiologic findings in 26 subjects with OT. The main findings included 13.0 to 18.6 Hz leg tremors while standing with varied patterns of phase relationships between the antagonists of the ipsilateral leg and between the homologous muscles of the contralateral leg, short latency tremor onset upon standing with abrupt cessation after sitting, coexistence of tremors in the cranial structures and the arms, and sense of unsteadiness without actual falls. Although the oscillator of OT is most likely located in the brainstem, cerebral cortex, basal ganglia, and cerebellum may also be involved in its pathogenesis.

Graves Disease and Isolated Orthostatic Tremor

“…1 Rare failures are usually explained by poor lead placement, lead fracture, or implantable pulse generator (IPG) failure. At times, DBS failure cannot be attributed to hardware malfunction and other causes must be sought.…”

“…1,2 Women are more frequently affected, and the age at onset can vary between 30 and 80 years. [1][2][3] We describe a patient with Graves disease who presented with OT without other systemic manifestations.…”

Temblor ortostático como causa de inestabilidad postural en enfermedad de Parkinson: Caso clínico

“…El temblor ortostático es una condición que aparece en la edad media de la vida y suele presentarse como sensación de inestabilidad asociado a marcha temerosa, sin signología cerebelosa y con escasas caídas 3 . Su causa es desconocida y presenta una asociación poco clara con temblor esencial.…”

“…El temblor ortostático es una forma de temblor, generalmente de alta frecuencia, presente casi exclusivamente en la postura de pie y que afecta en mayor medida a las extremidades inferiores, manifestándose como inestabilidad postural 3,4 . Debido a su alta frecuencia no es visible al observador ni es percibido por el paciente y sólo es detectable al examen clínico por la palpación de las extremidades afectadas 3 .…”

“…Debido a su alta frecuencia no es visible al observador ni es percibido por el paciente y sólo es detectable al examen clínico por la palpación de las extremidades afectadas 3 . En los últimos años han surgido diversos reportes demostrando la presencia de temblor ortostático en sujetos afectados de EP 4,5 .…”