[Orthostatic tremor - a disregarded diagnosis]

Area of Science:

• Neurology
• Movement Disorders

Background:

• Orthostatic tremor is a rare neurological condition characterized by a synchronized, bilateral, high-frequency tremor (13-18 Hz).
• It primarily affects leg and trunk muscles during standing, causing significant unsteadiness.
• Symptoms typically decrease upon sitting or walking.

Purpose of the Study:

• To describe the key features and potential pathophysiology of orthostatic tremor.
• To highlight its impact on patient balance and proprioception.

Main Methods:

• Clinical observation and description of orthostatic tremor characteristics.
• Review of proposed pathophysiological mechanisms involving the cerebello-thalamo-cortical network.

Main Results:

• Orthostatic tremor presents as a high-frequency (13-18 Hz) tremor affecting stance.
• Patients experience intense unsteadiness, which is relieved by postural changes.
• Pathophysiology is thought to involve the cerebello-thalamo-cortical network and proprioceptive disturbances.

Conclusions:

• Orthostatic tremor is an underdiagnosed condition impacting balance and postural control.
• Disruption in the cerebello-thalamo-cortical network is implicated in its pathophysiology.
• Proprioceptive deficits likely exacerbate the feeling of unsteadiness.