Shaking on Standing: A Critical Review

Mov Disord Clin Pract. 2014 Jun 12;1(3):173-179. doi: 10.1002/mdc3.12053. eCollection 2014 Sep.


Orthostatic tremor is a rare condition, though its exact prevalence is unknown, which is clinically characterized by a feeling of unsteadiness or being about to fall on standing and which disappears on walking, sitting, or lying down. It is generally accepted that classic orthostatic tremor manifests with a high-frequency tremor (>13 Hz) of the legs when standing. However, a number of patients initially reported as orthostatic tremor did not actually have such electrophysiological features. It is our experience that there is a clinical spectrum of different conditions presenting as shaking on standing, and this highlights the importance of the electrophysiology to aid the differential diagnosis of these disorders. Here, we provide a critical review of the clinical spectrum of shaking on standing, along with demonstrative electrophysiological recordings of some of these conditions.

Keywords: Parkinson's disease; essential tremor; orthostatic myoclonus; orthostatic tremor; tremor.

Publication types

  • Review