[Orthostatic tremor].

BACKGROUND

Orthostatic tremor is a rare disease characterized by difficulty with standing still. Patients often undergo a long diagnostic search and often feel underrecognized, partly due to unfamiliarity of physicians with the disease.

CASE DESCRIPTION

We report a 72-year-old male experiencing difficulty in standing still, accompanied by a tingling, trembling and painful sensation in the legs, over the last ten years. Several orthopedic and neurological causes had been suspected until neurological examination revealed a 'helicopter sign' upon auscultation of the leg muscles. Tremor registration showed a 14 Hz tremor in the legs upon standing, confirming the diagnosis of orthostatic tremor. There was moderate improvement with pharmacological treatment.

CONCLUSION

Orthostatic tremor should be suspected in patients with instability or atypical symptoms upon standing. A neurological referral including tremor registration is recommended in these cases.