A 72-year-old lady presented with 2-year history of unsteadiness on standing. Her Unified Parkinson’s disease rating scale (UPDRS)-III, OFF state score was 21. EMG recording revealed a 15–16 Hz tremor with a burst duration of 25 ms, present on standing and absent at rest and walking. Her auscultation over the gastrocnemius muscle revealed helicopter sign suggestive of fast orthostatic tremor.
Results
#1. What should be the choice of therapy in the management of orthostatic tremor?
A fast-orthostatic tremor (OT) may present as unsteadiness could be observed in a case of parkinson’s disease. OT may also precede or occur several years after the onset of parkinsonian symptoms. In this case, OT was bilateral and asymmetric which concurred with the asymmetric parkinsonism. This symptom are often nonresponsive to levodopa and benzodiazepines must be prescribed to adequately control the orthostatic tremor and reduce disability.
