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Published on: October 4, 2021
Levodopa-Responsive Primary Slow Orthostatic Tremor: A Premotor Sign of Parkinson's Disease?
Fumihito Yoshii1,2, Wakoh Takahashi2, Koji Aono3
1Department of Neurology, Saiseikai Shonan Hiratsuka Hospital, Hiratsuka, Japan.
Abstract:
We present a case of primary orthostatic tremor (OT) responsive to dopaminergic medication. The patient was a 62-year-old woman, who had leg tremor on standing for 2 years. No parkinsonian or other neurological signs were observed. Surface electromyography of the quadriceps muscles showed regular 5-6 Hz muscle discharges. [123I]-FP-CIT DAT-SPECT imaging revealed decreased specific binding ratio values in the striatum compared with age-matched controls. Her leg tremor almost completely disappeared following administration of levodopa 200 mg and pramipexole 0.75 mg. Since her OT with low-frequency discharge was responsive to dopaminergic medication, we speculate that it may be a premotor sign of Parkinson's disease.
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