Background: Positional tremors arise when a patient's tremor is brought on during specific positioning of the involved body part. They can be distinguished from postural tremor, wherein a patient's tremor is elicited in any posture, and from task-specific tremor, wherein a patient's tremor occurs only during a certain task.
Cases: We describe two cases of positional tremor that are markedly improved with botulinum toxin injection.
Discussion: The term "positional" is a valuable descriptor for tremors. In patients with positional tremor, botulinum toxin may be beneficial for treatment. Lidocaine injection provides a transient way to test for the appropriateness of botulinum toxin injection in these patients.
Keywords: action tremor; botulinum toxin; lidocaine; muscle spindle.