Isolated leg tremor in a middle-aged woman: an unusual presenting symptom of Graves' disease

  • Jeong-Yoon Lee
  • Hyunjin Ju
  • Kayeong Im
  • Kyum-Yil KwonEmail author
Letter to the Editor


Action tremor of bilateral upper extremities characterized by low amplitude and high frequency is commonly seen in patients with hyperthyroidism [1, 2]. There have been a few cases of hyperthyroidism showing atypical neurological manifestation in the absence of systemic symptoms [3, 4]. However, isolated position-specific postural tremor confined to both lower extremities has never been reported in Graves’ disease. Herein, we are to present a patient newly diagnosed as Graves’ disease manifesting with isolated position-specific postural leg tremor.

Case report

A 49-year-old woman came to our movement disorder clinic presenting with slowly progressive involuntary movement of both legs which had started 6 months ago. She told that her legs wobbled with putting her feet on tiptoes while sitting or standing. She had no history of any medical illness, medication usage, alcohol consumption, or trauma. Initial vital sign showed 116/61 mmHg of blood pressure, 93 rates/min of heart...


Graves’ disease Hyperthyroidism Leg tremor Postural tremor 



This work was supported by the Soonchunhyang University Research Fund (the number is not applicable).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Written informed consent was obtained from the patient.

Supplementary material

Video: A 49-year-old woman exhibits position-specific postural leg tremor, 7–8 Hz by visual inspection, emerging with the following circumstances; putting her feet on tiptoes while sitting; or standing on one foot with the other tip-toeing on the ground (Video, the first part). Two months after the treatment of hyperthyroidism, her leg tremor disappears completely (Video, the later part). (MP4 19761 KB)


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Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.Department of Neurology, Soonchunhyang University Seoul HospitalSoonchunhyang University College of MedicineSeoulRepublic of Korea

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