Unilateral lower limb rest tremor is not necessarily a presenting symptom of Parkinson's disease

Mov Disord. 2010 May 15;25(7):924-7. doi: 10.1002/mds.23030.


Lower leg rest tremor is an uncommon symptom of neurological disease. Review of the files of 16 patients who presented with lower leg tremor (average age 58 +/- 16 years; average disease duration 6.8 +/- 8.5 years) yielded a diagnosis of Parkinson's disease (PD) in 5 and probable multiple system atrophy (MSA) in 3. In 4 patients with an indeterminate diagnosis, cardiac MIBG SPECT was positive in 3, indicating PD, and negative in one, suggesting MSA. Two patients each had psychogenic tremor and drug-induced parkinsonism. Although lower leg tremor is considered an unusual presentation of PD, it should raise suspicions of MSA and other neurodegenerative disorders.

MeSH terms

  • Diagnosis, Differential
  • Female
  • Functional Laterality / physiology*
  • Humans
  • Lower Extremity / physiopathology*
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / physiopathology*
  • Severity of Illness Index
  • Tremor / diagnosis*
  • Tremor / physiopathology*