Orthostatic Tremor

Abstract This chapter concerns orthostatic tremor (OT), a form of tremor that characteristically affects the legs during stance. The clinical features of OT are described in detail, including the findings obtained from the history and examination of patients with OT, along with its associations, social consequences and effects on mood, cognitive function, and quality of life. The investigation of patients with OT using blood tests, MR imaging, single-photon emission tomography (SPECT) dopamine transporter imaging, transcranial sonography, and functional imaging are detailed. The processes involved in differentiating the three subtypes of orthostatic tremor, namely primary orthostatic tremor, orthostatic tremor plus, and pseudo-orthostatic tremor, are discussed, along with a scheme for distinguishing these forms of OT from orthostatic myoclonus. The management of OT by simple measures medical therapy, deep brain stimulation, and chronic spinal cord stimulation, are detailed. The advances in understanding of the pathophysiology of OT are reported.