Perampanel as a treatment option for orthostatic tremor

Orthostatic tremor (OT) is a rare hyperkinetic movement disorder, characterized by a high-frequency tremor (13–21 Hz), that induces 'shaky legs' upon standing and affects patients' quality of life (QoL) [1]. No curative treatment exists, and currently prescribed medication is often insufficient. Recently, perampanel was introduced as a novel treatment option for OT. Current evidence is limited, and based on three case reports, stating 'complete resolution of OT symptoms' [2,3], and one observational cohort study (n = 20), which showed potential benefit of low-dose perampanel in OT patients [4].