Orthostatic Tremor and Orthostatic Myoclonus: Weight-bearing Hyperkinetic Disorders: A Systematic Review, New Insights, and Unresolved Questions

Hassan, Anhar; Gerpen, Jay A. van

doi:10.7916/d84x584k

Cited by 18 publications

(9 citation statements)

References 103 publications

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“…However, in our sample, orthostatic myoclonus (OM) was more prevalent than OT. Without electrophysiological assessment, it is not possible to differentiate between these entities, 2,27,29,30 highlighting the utility of this assessment. OM is a relatively recently described and has a broad spectrum of presentation with similar clinical presentation as OT, but sometimes without clear clinical finding of shaking.…”

Section: Discussionmentioning

confidence: 99%

“…Orthostatic tremor 2 • Classical orthostatic tremor: 13 to 18 Hz tremor in lower limbs while standing with high coherence between homologous muscles • Slow OT: frequency lower than 13 Hz and lower coherence • Reduced amplitude during leaning forward with the weight supported by the arms Orthostatic myoclonus 2,31 • Irregular bursts in the lower limbs with a mean EMG burst durations of 20-100 ms that appeared while standing with frequency of 3-7 Hz • Reduced amplitude during leaning forward with the weight supported by the arms Stiff-person syndrome…”

Section: Orthostatic Tremor/myoclonusmentioning

confidence: 99%

“…More studies are needed to standardize the protocols between centers and to promote the availability and use of these techniques among movement disorders clinics.The use of neurophysiological techniques to evaluate movement disorders is well established for myoclonus, stiff-person syndrome and orthostatic tremor (OT). [1][2][3] There is growing interest in the field, and methods are being developed to evaluate tremor, 4 especially for the diagnosis of functional tremor, 5 and other movements such as dystonia and tics. [6][7][8] Quantitative and objective neurophysiological assessment can help to define the predominant phenomenology and provide diagnoses that have prognostic and therapeutic implications.…”

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confidence: 99%

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Utility of Neurophysiological Evaluation in Movement Disorders Clinical Practice

Grippe

Chen

2023

Movement Disord Clin Pract

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BackgroundQuantitative and objective neurophysiological assessment can help to define the predominant phenomenology and provide diagnoses that have prognostic and therapeutic implications for movement disorders.ObjectivesEvaluate the agreement between initial indications and final diagnoses after neurophysiological evaluations in a specialized movement disorders center. Methods: Electrophysiological studies conducted for movement disorders from 2003 to 2021 were reviewed. The indications were classified according to predominant phenomenology and the diagnoses categorized in subgroups of phenomenology.ResultsA total of 509 studies were analyzed. 51% (259) of patients were female, with mean age of 51 years (ranges 5 to 89 years). The most common reasons for referral were evaluation of functional movement disorders (FMD), followed by jerky movements, tremor and postural instability. Regarding FMD referrals, there was a diagnostic change in 13% of the patients after electrophysiological assessment. The patients with jerky movements as indication had a diagnosis other than myoclonus in 27% of them, and tremor was not confirmed in 20% of the cases. In patients with an electrophysiological diagnosis of FMD, it was not suspected in 30% of the referrals. Similarly, tremor was not mentioned in the referral of 17% of the patients with this electrophysiological diagnosis and myoclonus was not suspected in 13% of the cases.ConclusionsElectrophysiological assessment has utility in the evaluation of movement disorders, even in patients evaluated by movement disorders neurologists. More studies are needed to standardize the protocols between centers and to promote the availability and use of these techniques among movement disorders clinics.This article is protected by copyright. All rights reserved.

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Section: Discussionmentioning

confidence: 99%

Section: Orthostatic Tremor/myoclonusmentioning

confidence: 99%

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confidence: 99%

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Utility of Neurophysiological Evaluation in Movement Disorders Clinical Practice

Grippe

Chen

2023

Movement Disord Clin Pract

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“… 1 , 2 Patients complain of instability on standing, with a normal to minimally affected gait. 3 , 4 Patients with POT are often severely disabled, there is no cure and treatment with medication or deep brain stimulation is often unsatisfactory. 3 …”

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confidence: 99%

The Phenomenology of Primary Orthostatic Tremor

Swinnen

Waal

Buijink

et al. 2022

Movement Disord Clin Pract

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Background The presence and prevalence of several neurological signs in patients with primary orthostatic tremor have not been systematically studied. Objectives To assess the prevalence of clinical features of primary orthostatic tremor. Methods Video‐based assessment by four raters of standardized neurological examination of 11 patients with primary orthostatic tremor. Results On standing, bent knees (7/11), hem sign (6/10), and a broad base of support (6/11) were the three most prevalent signs. Examination of gait revealed abnormal tandem gait (9/11) and bent knees (6/11) as the most prevalent clinical signs. In the arms, none of the patients displayed bradykinesia, ataxia, or dystonia. In the legs, ataxia was absent in all patients and bradykinesia was present in only one patient. Conclusions Abnormal tandem gait, bent knees, hem sign, and broad base on standing are the most prevalent clinical signs in primary orthostatic tremor. We did not encounter clear extrapyramidal or unequivocal cerebellar signs.

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“…Tremors can be driven by different oscillators and more than one type of tremor can co-exist in an individual. Correct diagnosis of tremor syndromes such as enhanced physiologic tremor and orthostatic tremors is based on physiologic criteria ( Hassan and van Gerpen, 2016 , Vial et al, 2019 ). Co-existence of tremor with other movement disorders such as myoclonus, dystonia is very well known and also highlighted in their paper by Everlo et al, 2022 , Bhatia et al, 2018 , Merchant et al, 2018 , Vial et al, 2019 .…”

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confidence: 99%

Emerging role of clinical neurophysiology in the diagnosis of movement disorders

Merchant

2022

Clinical Neurophysiology Practice

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Orthostatic Tremor and Orthostatic Myoclonus: Weight-bearing Hyperkinetic Disorders: A Systematic Review, New Insights, and Unresolved Questions

Cited by 18 publications

References 103 publications

Utility of Neurophysiological Evaluation in Movement Disorders Clinical Practice

Utility of Neurophysiological Evaluation in Movement Disorders Clinical Practice

The Phenomenology of Primary Orthostatic Tremor

Emerging role of clinical neurophysiology in the diagnosis of movement disorders

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