August 6, 2015: Primary orthostatic tremor

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August 6, 2015

Primary orthostatic tremor

Primary orthostatic tremor is characterized by a rapid tremor of the legs while standing. It is partially or completely relieved by walking or sitting such that affected individuals attempt to sit or walk immediately because of a fear of falling. Electrophysiology has shown that it is a strong posture-related 16-Hz tremor, which is different from essential tremor that exhibits a 6-8 Hz tremor. A family history of primary orthostatic tremor is uncommon. It is considered as a peripheral manifestation of a central oscillation. Its relation to Parkinson's disease is not clear so far, although some investigators suggest that the two may be related. Medications are generally unsatisfactory but clonazepam is widely used as the first line treatment1,2.


  1. Yaltho TC, Ondo WG. Orthostatic tremor: a review of 45 cases. Parkinsonism & related disorders 2014; 20: 723-725.
  2. McAuley JH, Britton TC, Rothwell JC, Findley LJ, Marsden CD. The timing of primary orthostatic tremor bursts has a task-specific plasticity. Brain 2000; 123: 254-266.

Submitted by Weizhen Wang, MD and Wenzhuan He, MD, Rutgers/NJMS Department of Neurology and Neurosciences.

Disclosures: Drs. Wang and He report no disclosures.

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