Leg Tremor, An Anxious Patient, A Challenging Treatment

Orthostatic tremor (OT) is one of the rare abnormal movement conditions characterized by leg tremors of 13-18 Hz upon standing and is often diminished upon walking or sitting. The exact pathophysiology of OT is still not fully understood, and it is uncertain whether the tremor causes unsteadiness on standing or vice versa. Treatment is a tremendous challenge. Medication toxicity with ineffective medications may likely cause distress to the patients and the physicians. Gabapentin, clonazepam, levodopa, and pregabalin are among the medications that have been used. We herein report on an elderly patient with OT, distressed, and anxious who improved significantly with physiotherapy as an adjunct therapy to the conventional medications.