News, Articles, Organizations & Resources:
OT Survey** - members of the OT Resource submitted anonymous data for several years and the result was the Orthostatic Tremor Survey , it was recently closed to new input.
OT Polls** - There is currently an active poll on medicines/treatments for Orthostatic Tremor that have been tried, with and without success. Please visit the following link and view the current data and participate if you haven’t already.
**THIS POLL/SURVEY IS FOR GENERAL INFORMATION, AND ANY DECISION TO START OR STOP USING MEDICATION CAN ONLY BE MADE BY YOUR PHYSICIAN
Links to published articles on Orthostatic Tremor and related topics:
If you have a published article and would like the OT Resource to link to it, please let us know.
Tinnitus (ringing in ears) with OT .... reported bilateral tinnitus, which increased with instability, but no episodes of vertigo or hearing loss - read more...
Report: Levetiracetam (Keppra) is ineffective in the treatment of orthostatic tremor
Familial orthostatic tremor: An additional report in siblings - a family in which 2 siblings have clinically and physiologically documented OT.
Acoustic Startle Response in Patients with Orthostatic Tremor - Our results increase the possibility that brainstem and diencephalon serve as anatomic substrates in orthostatic tremor pathogenesis.
Clinical and Neurophysiologic Spectrum of Orthostatic Tremor: Case Series of 26 Subjects - This report is one of the largest OT series describing clinical and neurophysiologic ﬁndings in 26 subjects with OT
Body Tremors Have A Genetic Cause The latest issue of The American Journal of Human Genetics now reveals that researchers from Montreal University and its affiliated CHU Sainte-Justine and CHUM hospitals have managed to link some cases of Essential Tremor (ET) to a specific genetic problem.
Orthostatic Tremor a review of 40 Cases - review of medical records of 40 patients seen at the Baylor College of Medicin Parkinson’s Disease Center and Movement Disorders Clinic between 1987 and 2010. A review of 40 cases in which 15 percent of the sampling had “OT plus” additional neurological features including Parkinson’s, restless legs syndrome, 2 with parkinsonism, 1 with ataxia and 1 with hemifacial spasm. Contains a chart of OT, “OT plus” and All OT
Unilateral Standing Leg Tremor as the Initial Manifestation of Parkinson Disease : There are several forms of standing leg tremor (SLT) in that it is present only while standing, and disappears while a subject is sitting down or walking
Slow Orthostatic Tremor can persist when walking backwards - Classically orthostatic tremor and the associated symptom of intense unsteadiness disappear with ambulation1. Here we describe a patient with cerebellar atrophy who presented with slow orthostatic tremor, which disappeared when walking forwards, but persisted when walking backwards.
Shaky legs? Think POT! .... three cases seen in a general neurology clinic over a 15-month period to highlight the typical clinical features which should alert clinicians to the possibility of this diagnosis.
Characterizing orthostatic tremor: a study of 56 patients : The age at OT onset distribution had a single peak and was a decade later than essential tremor (ET), which is bimodal. Symptomatic leg tremor was ubiquitous, but OT affected the arms in 50%, head (20%), trunk (16%) and voice and tongue (both 7%) of cases.
Is the spinal cord the generator of 16-Hz orthostatic tremor? This raises the possibility that the spinal cord could be the source of orthostatic tremor.
A 55 minute video - "Orthostatic Tremor" Visiting Professor: Diego Torres-Russotto, MD Washington University in St. Louis, School of Medicine. Scroll down the page and look for the first listing under "November Grand Rounds". November 29, 2007 "Orthostatic Tremor" Visiting Professor: Diego Torres-Russotto, MD Washington University in St. Louis, School of Medicine
Link: CONCLUSION: Analysis of power spectra from posturographic recordings is a simple, quick method to screen for primary orthostatic tremor. The condition might be more common than previously assumed. It is important to identify patients with primary orthostatic tremor because they might be misdiagnosed and left without treatment.
Presentation notes from the October 8th talk at the National Tremor Foundation by Dr. Peter Bain, Charing Cross Hospital, London
Gabapentin can improve postural stability and quality of life in primary orthostatic tremor. : Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway.
Four patients who developed orthostatic tremor after exposure to dopamine blocking drugs
We describe changes in the extent of sway in a man with orthostatic tremor (OT) who reported increased stability after alcohol.
We have reviewed these aspects in 41 OT patients fulfilling current diagnostic criteria, seen at our institution between 1986 and 2001.
The aim of this study was to determine if orthostatic tremor is invariably associated with the orthostatic and weight bearing conditions in the arms and legs, and to investigate the features of orthostatic tremor under different levels of peripheral loading.
[123I]-FP-CIT-SPECT demonstrates dopaminergic deficit in orthostatic tremor There is increasing evidence of a potential role of the dopaminergic system in orthostatic tremor (OT)
Quality of life in patients with orthostatic tremor :We conclude that OT strongly impacts on QoL (quality of life). The results highlight the importance of recognizing and treating depression in patients with OT.
Gabapentin in the treatment of tremor: 63 patients aged 59.4 years (SD, 16 years): 34 essential tremor, 16 Parkinson s disease tremor, 10 multiple sclerosis tremor, 4 writing tremor and 3 orthostatic tremor.
Technology Review has an interesting article about a bioengineer at Boston University that is using "noise" to enhance weak signals that are related to balance. This link is only for a preview to the article and a slide show.
Developing Unique Brain Maps To Assist Surgery And Research "Microscopic images inside the living brain will transform diagnosis and treatment of diseases such as multiple sclerosis, Parkinson's disease, Alzheimer's disease and Huntington's disease," A/Prof Egan said.
Primary orthostatic tremor is an exaggeration of a physiological response to instability.Mov Disord 2003 Feb
Its prevalence accounts for around 4% for tremors explored in neurophysiology-Rev Med Interne 2002 Feb;23(2):193-7
Primary orthostatic tremor: slow harmonic component as responsible of instability The full report in spanish can be found here
The pathophysiology of tremor.-Orthostatic tremor is likely to originate in hitherto unidentified brainstem nuclei.
Orthostatic tremor arises from an oscillator in the posterior fossa. tested the hypotheses that orthostatic tremor is generated by a central oscillator and that the tremor is expressed through spinal Ib interneurons.
The main aim of this study was to see if the characteristic postural tremor in OT can be identified with force platforms. 2001 Feb;13 London UK
Gabapentin in orthostatic tremor: results of a double-blind crossover with placebo in four patients.
Effective treatment of orthostatic tremor with gabapentin. Mov Disord, 1998 Sep, 13:5, 829-31
"Primary" orthostatic tremor. 10 clinical electrophysiologic observations
observations of 3 men and 7 women, 37 to 74 years old with OT
A dissociation between subjective and objective unsteadiness in primary orthostatic tremor.
"standing under four conditions (eyes open or closed, feet together or apart) in six patients with OT. "
A more indepth look at the classification of tremors,
Another good reference on classification of tremors
Organizations and Groups
The National Organization for Rare Disorders (NORD), a 501(c)3 organization, is a unique federation of voluntary health organizations dedicated to helping people with rare "orphan" diseases and assisting the organizations that serve them. NORD is committed to the identification, treatment, and cure of rare disorders through programs of education, advocacy, research, and service.
The Genetic and Rare Diseases Information Center (GARD) was created in 2002 by the National Human Genome Research Institute (NHGRI) and the Office of Rare Diseases Research (ORDR) - two agencies at the National Institutes of Health (NIH) - to help people find useful information about genetic and rare diseases.
Disability Resources, inc. is a nonprofit organization established to promote and improve awareness, availability and accessibility of information that can help people with disabilities live, learn, love, work and play independently.
The National Tremor Foundation- British foundation for sufferers of all types of tremor
website of the International Tremor Foundation
organization for movement disorders, info on related disorders
USA -Social Security - Information on disability benefits
Tremor Action Network : National non-profit dedicated to increasing awareness of essential tremor by advocating for a cure through research. Offers support for patients, family members, and caregivers through a quarterly newsletter, videos, and guidance from advocates.
Medical Search Engines
SCIRUS-Search Engine for Scientific Information view the latest published research papers on Orthostatic Tremor
PubMed view the latest published research papers on Orthostatic Tremor from the US National Library of Medicine - NIH
WebMD WebMD offers credible and in-depth medical news, features, reference material, and online community programs.
TIP FOR SEARCHING THE WEB- when you are searching for information on OT, make sure that you put the words orthostatic and tremor in quotes like this "orthostatic tremor". This will force the search engines to search for the phrase "orthostatic tremor" only when the words are together. Otherwise, you will get results for websites where the two words exist but not necessarily together. Please email me if you find any websites that you feel would be helpful, and if you find that any of the of the above links are broken.
This website is intended to be an informal guide, and is not a substitute for medical advice.