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Vol. 63. Issue 2.
Pages 120-124 (March - April 2012)
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Vol. 63. Issue 2.
Pages 120-124 (March - April 2012)
Brief communication
DOI: 10.1016/j.otoeng.2012.03.010
Orthostatic Tremor Inducing Instability
Temblor ortostático como causa de inestabilidad
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Raquel Manrique-Huartea,
Corresponding author
rmanrique@unav.es

Corresponding author.
, Juan Arcochab, Nicolás Pérez-Fernándeza
a Departamento de Otorrinolaringología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
b Departamento de Neurofisiología, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
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Tables (2)
Table 1. Demographic Data, Physical Examination and Complementary Tests.
Table 2. Classification of Pathologies Which Appear With Tremor in Their Frequency Range and Type of Tremor According to the Movement Disorder Society Consensus (1998).
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Abstract

Orthostatic tremor (OT) is a neurological disease of unknown aetiology. It is defined by the presence of a 10–20Hz tremor in the legs while standing still. Symptoms described are dizziness and instability that diminish if the patient sits down or leans on something; drinking small amounts of alcohol significantly reduces OT. Due to the dizziness and/or unsteadiness, these patients are usually referred to the neuro-otology department. We report 4 cases diagnosed with OT. The diagnosis of OT should be considered for patients with instability. The clinical history is a key factor to suspect this entity, and the diagnosis is given by the register of 10–20Hz contractions on limb electromyography. Treatment for this disease consists of medical treatment; the first option is clonazepam.

Keywords:
Instability
Electromyography
Orthostatic tremor
Resumen

El temblor ortostático (TO) es una enfermedad neurológica de origen desconocido caracterizada por un temblor de 10-20Hz en las piernas en bipedestación. Se manifiesta por mareo e inestabilidad, que típicamente mejoran al apoyarse o sentarse y la ingesta de pequeñas cantidades de alcohol lo reduce de manera significativa. Se muestran 4 casos clínicos atendidos en nuestra consulta cuyo diagnóstico sugiere ser el de TO. Consideramos que ante un paciente con inestabilidad, es preciso plantearse como diagnóstico diferencial un TO. La historia clínica nos orienta hacia esta entidad y en caso de sospecha, el diagnóstico definitivo viene dado por el registro de la electromiografía en las extremidades inferiores en condición de reposo sentado y en ortostatismo donde se registra un temblor de 10-20Hz. El tratamiento es médico y, se emplea el clonazepam como primera opción terapéutica.

Palabras clave:
Inestabilidad
Electromiografía
Temblor ortostático

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