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[Orthostatic tremor: clinical aspects, pathophysiology and therapy]
EEG-EMG Zeitschrift Fur Elektroenzephalographie, Elektromyographie Und Verwandte Gebiete
|March 1, 1987
Summary
Orthostatic tremor involves a 16 Hz rhythmic muscle activity, not just during standing. This central nervous system oscillator is triggered by stance regulation, impacting balance.
Area of Science:
- Neurology
- Neurophysiology
Background:
- Orthostatic tremor (OT) typically presents as isolated leg and trunk muscle activity during standing.
- This case study explores an atypical presentation of orthostatic tremor in a female patient.
Observation:
- The patient exhibited a 16 Hz synchronized tremor in leg and arm muscles during various activities (sitting, lying, standing).
- An 8 Hz tremor, linked to unsteadiness, was observed alongside the 16 Hz tremor.
- Single motor unit firing occurred at 8 Hz during tremor bursts, suggesting a non-motoneuronal origin for the 16 Hz pattern.
Findings:
- The 16 Hz tremor was present across different postures, not solely during standing.
- A common central nervous system generator was inferred due to synchronized muscle activity.
- Primidone treatment normalized tremor in sitting/lying but not standing/walking.
Implications:
- Suggests an unknown central oscillator drives orthostatic tremor.
- Stance regulation pathways may control the activation of this central oscillator.
- Highlights the complex pathophysiology of orthostatic tremor beyond typical presentations.