Orthostatic Tremor as Initial Presentation of Parkinson's Disease.

Orthostatic tremor is rare and is defined as tremor that occurs when standing and affects the lower limbs and trunk, with a frequency of 14-16 Hz. It disappears when leaning on objects and walking. Patients with orthostatic tremor usually have a subjective feeling of unsteadiness. Although orthostatic tremor occurs predominantly in isolation, it has been reported in association with Parkinson's disease, although rarely. We described a patient who presented initially with history and clinical examination which are strongly suggestive of primary orthostatic tremors, but developed parkinsonism features 10 months after the onset of tremor and responded well to levodopa therapy.