Shaking on Standing: A Critical Review.
Level 5 - mechanism / opinion, no new human data
Narrative review and expert clinical commentary without systematic review methodology
PubMed 30363785 · doi:10.1002/mdc3.12053
What was done
The authors conducted a narrative review of the clinical spectrum of disorders characterized by shaking on standing, incorporating demonstrative electrophysiological recordings to evaluate diagnostic distinctions.
What was found
The abstract reports no quantitative trial data, meta-analytic statistics, or exact prevalence figures. It notes that classic orthostatic tremor is characterized by a high-frequency tremor (>13 Hz) in the legs when standing that disappears upon sitting, walking, or lying down. The authors report that a subset of patients presenting with orthostatic shaking lack these electrophysiological findings, indicating a broader clinical spectrum requiring electrophysiological discrimination.
Why it matters
Clinical presentation alone is insufficient to accurately diagnose orthostatic tremor. Objective electrophysiological recording is critical for differentiating true orthostatic tremor from distinct clinical mimics presenting with similar orthostatic unsteadiness.
Limits
This is an unsystematic narrative review representing expert opinion and illustrative cases rather than a systematic synthesis. The abstract provides no sample sizes, inclusion criteria, or numerical diagnostic accuracy metrics.
Cited by
- supports Orthostatic tremor presents as rapid leg shaking when standing still that improves or resolves when walking or sitting.