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Table 3 Secondary orthostatic tremors

From: Lessons I have learned from my patients: everyday life with primary orthostatic tremor

Associated clinical features neuro-imaging abnormalities High/slowtremor frequency Neurological disorders
Parkinsonism, gait difficulty, postural instability Slow 6–7 Hz tremor Acqueduc stenosis
Truncal ataxia, cranial nerve involvement Fast orthostatic tremor (15 Hz) Pontine lesions/midbrain lesions
Broad based ataxic gait, cerebellar tremor, dysmetria, speech involvement, saccadic pursuit, dysmetria of saccades From fast 14–15 Hz tremor to the lower range of OT (13 Hz tremor) Cerebellar degeneration, Spino-cerebellar ataxia (genetic, e.g. SCA2)
Ataxia, sensory disturbances, pyramidal signs, relapsing remitting/progressive Very slow 4 Hz tremor Multiple sclerosis
Postural instability, urinary symptoms 14–13 Hz Spinal cord lesion
Sensory disturbances, mild weakness of the upper limbs, postural tremor 6–7 Hz Neuropathy (IgG and IgA gammapathy or polyradiculopathy, paraneoplasic disorders
  1. Rare cases of orthostatic tremor have been reported with dopamine blocker agents (neuroleptics), vitamin B12 deficiency (same frequency as POT°, spastic paraparesis (16 Hz), stiff-person and Graves disease