Posturography can be used to screen for primary orthostatic tremor, a rare cause of dizziness.
OBJECTIVE
Primary orthostatic tremor is a rare neurologic condition of unknown origin characterized by a 10- to 20-Hz tremor in the legs while standing. Patients with primary orthostatic tremor usually complain of dizziness and unsteadiness that is relieved if they sit down or start to walk around. These patients might be referred to neurotology clinics. Previously, the only way to make the diagnosis has been by means of surface electromyographic recordings from the lower limbs during standing. The authors wanted to study whether posturography can be used to screen for primary orthostatic tremor.


METHODS
Retrospective case review.


METHODS
Balance clinic at a tertiary referral center.


METHODS
From September 2000 to August 2002, 701 patients were investigated at the authors' balance clinic.


METHODS
Static posturography on a force platform with 50-Hz sampling frequency. Recordings were made during 120 seconds of quiescent stance with open or closed eyes.


METHODS
Fast-Fourier transformation (FFT) analysis of recorded torque in the fore-to-aft direction to quantify the spectral power distribution in the range of 0 to 25 Hz. Visual inspection of power spectrum plots was performed.


RESULTS
Five patients (0.7%) were identified (1 man and 4 women; mean age, 56 yr; age range, 36-73 yr) with narrow peaks at 8.5 to 18 Hz in the power spectra of their posturographic recordings. Surface electromyographic recordings during standing confirmed their diagnosis of primary orthostatic tremor.


CONCLUSIONS
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.
Karlberg
Mikael
M
Department of Otorhinolaryngology-Head and Neck Surgery, Lund University Hospital, Lund, Sweden. mikael.karlberg@skane.se
Fransson
Per-Anders
PA
Magnusson
Måns
M
D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D004244:Dizziness / Q000209:etiology* / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D012189:Retrospective Studies; D014202:Tremor / Q000175:diagnosis* / Q000503:physiopathology; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology