Orthostatischer Tremor

Willeit, J.; Deisenhammer, F.; Ransmayr, G.; Gerstenbrand, F.

doi:10.1055/s-2008-1063781

Cited by 7 publications

(3 citation statements)

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“…52,53 Finally, in contrast to the tremor of essential tremor, OT shows little or no response to propanolol. 5,13,56 Orthostatic myoclonus is a disorder that was first reported in 2007 in 15 elderly subjects. 57 This condition is characterized by unsteadiness during orthostatism and/or during gait and short duration myoclonic In Parkinson's disease, low-frequency (4-6 Hz) leg tremor is rarely seen while patients are standing.…”

Section: Differential Diagnosismentioning

confidence: 99%

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Orthostatic Tremor: An Update on a Rare Entity

Benito‐León

Domingo-Santos

2016

Tremor and Other Hyperkinetic Movements

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Background: Orthostatic tremor (OT) remains among the most intriguing and poorly understood of movement disorders. Compared to Parkinson's disease or even essential tremor, there are very few articles addressing more basic science issues. In this review, we will discuss the findings of main case series on OT, including data on etiology, pathophysiology, diagnostic approach, treatment strategies, and outcome. Methods: Data for this review were identified by searching PUBMED (January 1966 to August 2016) for the terms ''orthostatic tremor'' or ''shaky leg syndrome,'' which yielded 219 entries. We did not exclude papers on the basis of language, country, or publication date. The electronic database searches were supplemented by articles in the authors' files that pertained to this topic. Results: Owing to its rarity, the current understanding of OT is limited and is mostly based on small case series or case reports. Despite this, a growing body of evidence indicates that OT might be a progressive condition that is clinically heterogeneous (primary vs. secondary cases) with a broader spectrum of clinical features, mainly cerebellar signs, and possible cognitive impairment and personality disturbances. Along with this, advanced neuroimaging techniques are now demonstrating distinct anatomical and functional changes, some of which are consistent with neuronal loss. Discussion: OT might be a family of diseases, unified by the presence of leg tremor, but further characterized by etiological and clinical heterogeneity. More work is needed to understand the pathogenesis of this condition.

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Section: Differential Diagnosismentioning

confidence: 99%

“…7 Unlike essential tremor, OT does not improve either with alcohol or propranolol. 40,56 Of all the medications, clonazepam is probably the first-line medication in the treatment of primary and secondary OT. 5,10,23,39 This drug reduces tremors in about one-third of people who have the disorder.…”

Section: Pharmacological Agentsmentioning

confidence: 99%

Orthostatic Tremor: An Update on a Rare Entity

Benito‐León

Domingo-Santos

2016

Tremor and Other Hyperkinetic Movements

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“… 52 , 53 Finally, in contrast to the tremor of essential tremor, OT shows little or no response to propanolol. 5 , 13 , 56 …”

Section: Phenomenology and Clinical Featuresmentioning

confidence: 99%

Orthostatic Tremor: An Update on a Rare Entity

Benito‐León

Domingo-Santos

2016

Tremor and Other Hyperkinetic Movements

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Natural history and syndromic associations of orthostatic tremor: A review of 41 patients

et al. 2004

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Orthostatic tremor (OT) is a rare condition characterized by unsteadiness when standing still that is relieved when sitting or walking and is thought to arise from a central generator in the cerebellum or brainstem. OT is considered to be a distinct, discrete condition, and little is known about its demographic characteristics, natural history, associated features, and treatment response. We have reviewed these aspects in 41 OT patients fulfilling current diagnostic criteria, seen at our institution between 1986 and 2001. We classified 31 (75%) as having idiopathic "primary OT" either with (n = 24) or without an associated postural arm tremor. We found that 10 of 41 (25%) cases had additional neurological features, and we defined this group as having "OT plus" syndrome. Of these 10, 6 had parkinsonism; 4 of these had typical Parkinson's disease (PD), 1 had vascular and 1 had drug-induced parkinsonism. Among the remaining 4 patients, 2 had restless legs syndrome (RLS), 1 had tardive dyskinesia, and 1 orofacial dyskinesias of uncertain etiology. One patient with PD and the patient with vascular parkinsonism also had RLS. Age at onset was significantly earlier in the "primary OT" (mean +/- SD, 50.4 +/- 15.1) than in the "OT plus" (61.8 +/- 6.4; z = 2.7; P =.006) group. In 7 of the 10 "OT plus" patients, OT leg symptoms preceded the onset of additional neurological features. OT appeared to be underdiagnosed, and on average, it took 5.7 years from the initial complaints until a diagnosis was made. In general, treatment response to a variety of drugs such as clonazepam, primidone, and levodopa was poor. In most cases, OT symptoms remain relatively unchanged over the years, but in 6 of 41 cases (15%), the condition gradually worsened over the years, and in some of these cases, symptoms spread proximally to involve the trunk and arms. OT may not be a discrete disorder as commonly believed and associated features like parkinsonism present in nearly 25% of cases. Dopaminergic dysfunction may have a role in the pathophysiology of this disorder.

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Orthostatischer Tremor

Cited by 7 publications

References 0 publications

Orthostatic Tremor: An Update on a Rare Entity

Orthostatic Tremor: An Update on a Rare Entity

Orthostatic Tremor: An Update on a Rare Entity

Natural history and syndromic associations of orthostatic tremor: A review of 41 patients

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