Paraneoplastic Orthostatic Tremor Associated with Small Cell Lung Cancer

vealed a wild and disabling shaking of the arms, legs and head while attempting to stand or walk. The shaking had a frequency of 3–5 Hz. When she lay down, the examination was completely normal. No other neurological symptoms were present. Routine laboratory tests (including thyroid functions, calcium and phosphate), EEG and MRI of the brain were normal. Six weeks after the beginning of symptoms, she became progressively dyspnoeic and lost weight. An SCLC in the right upper lobe with lymph node and liver metastases was diagnosed. Anti-Hu antibodies were present in serum (titre of 1: 3,200). A few days after the initiation of chemotherapy, the shaking gradually disappeared, and within a week only a slight tremor of the hands remained. She was able to stand and walk again till she died of respiratory failure 9 months later.