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 |