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Related Experiment Video

Updated: May 22, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

[Orthostatic tremor: unsteadiness while standing still].

Natalie J Wiendels¹, Selma C Tromp

¹St. Antonius Ziekenhuis, afd. Klinische neurofysiologie, Nieuwegein/Utrecht.

Nederlands Tijdschrift Voor Geneeskunde

|May 24, 2012

Summary

Orthostatic tremor causes leg unsteadiness when standing, often mistaken for balance issues. Diagnosis involves EMG confirming a 13-18 Hz tremor, with clonazepam as a potential treatment.

Area of Science:

Neurology
Movement Disorders

Background:

Orthostatic tremor (OT) is a rare neurological condition characterized by leg instability during standing.
Patients often report balance disturbances rather than perceptible tremors, complicating early recognition.

Observation:

Presents three cases of OT, highlighting the characteristic symptom of leg unsteadiness relieved by walking or sitting.
Clinical examination may reveal subtle leg tremors, audible on auscultation or palpable in muscles.
Electromyography (EMG) is crucial for diagnosis, showing a pathognomonic 13-18 Hz tremor during upright stance.

Findings:

The pathophysiology of orthostatic tremor remains unclear, with theories suggesting a proprioceptive feedback disorder.
Associated conditions like Parkinson's disease, Graves' disease, and central nervous system lesions require exclusion via investigations.

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Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance

Published on: March 21, 2013

An Instrumented Pull Test to Characterize Postural Responses

An Instrumented Pull Test to Characterize Postural Responses

Published on: April 6, 2019

Implications:

Early diagnosis of orthostatic tremor is essential for appropriate management.
Clonazepam is identified as a first-line treatment, with gabapentin as an alternative.
Levodopa may benefit patients with co-existing parkinsonism.