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

摘要: Orthostatic tremor (OT) is a rare condition characterized by unsteadiness when standing still that relieved sitting or walking and thought to arise from central generator in the cerebellum brainstem. OT considered be distinct, discrete condition, little known about its demographic characteristics, natural history, associated features, treatment response. We have reviewed these aspects 41 patients fulfilling current diagnostic criteria, seen at our institution between 1986 2001. classified 31 (75%) as having idiopathic “primary OT” either with (n = 24) without an postural arm tremor. found 10 of (25%) cases had additional neurological we defined this group “OT plus” syndrome. Of 10, 6 parkinsonism; 4 typical Parkinson's disease (PD), 1 vascular drug-induced parkinsonism. Among remaining patients, 2 restless legs syndrome (RLS), tardive dyskinesia, orofacial dyskinesias uncertain etiology. One patient PD parkinsonism also RLS. Age onset was significantly earlier (mean ± SD, 50.4 15.1) than (61.8 6.4; z 2.7; P .006) group. In 7 leg symptoms preceded features. appeared underdiagnosed, on average, it took 5.7 years initial complaints until diagnosis made. general, response variety drugs such clonazepam, primidone, levodopa poor. most cases, remain relatively unchanged over years, but (15%), gradually worsened some spread proximally involve trunk arms. may not disorder commonly believed features like present nearly 25% cases. Dopaminergic dysfunction role pathophysiology disorder. © 2004 Movement Disorder Society