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Richard L. Cristea, MD; Hershel Goren, MD
The Cleveland Clinic Foundation 9500 Euclid Ave Cleveland, OH 44195

Arch Neurol. 1991;48(11):1119.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—A recent patient encounter made us realize that Parkinson's disease is part of the differential diagnosis of orthostatic tremor.

A 65-year-old man consulted us for confirmation of a diagnosis of orthostatic tremor with symptoms present for 5 years. He brought with him a copy of Heilman's classic article¹ on orthostatic tremor. Indeed, on examination, we observed the typical manifestation of orthostatic tremor, ie, rapid, irregular, asynchronous tremor of the lower limbs and trunk coming on while the patient was standing. As did Heilman, we noted essential tremor of the upper limbs. However, the patient also had typical manifestations of Parkinson's disease that Heilman had carefully excluded in his patients—bradykinetic gait with festination, rigidity, seborrhea, virtually absent arm swing, and no rest tremor. We had the impression that the orthostatic tremor came on primarily when the patient became akinetic from his Parkinson's disease. Five weeks after starting . . . [Full Text PDF of this Article]

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