Holmes' tremor as a delayed complication of thalamic stroke

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
William Alves MartinsAntonio Carlos Huf Marrone

Abstract

Movement disorders are not commonly associated with stroke. Accordingly, thalamic strokes have rarely been associated with tremor, pseudo-athetosis and dystonic postures. We present a 75-year-old man who developed a disabling tremor 1 year after a posterolateral thalamic stroke. This tremor had low frequency (3-4 Hz), did not disappear on focus and was exacerbated by maintaining a static posture and on target pursuit, which made it very difficult to perform basic functions. MRI demonstrated an old ischemic lesion at the left posterolateral thalamus. Treatment with levodopa led to symptom control. Lesions in the midbrain, cerebellum and thalamus may cause Holmes' tremor. Delayed onset of symptoms is usually seen, sometimes appearing 2 years after the original injury. This may be due to maturation of a complex neuronal network, leading to slow dopaminergic denervation. Further studies are needed to improve our understanding of this unique disconnection syndrome.

References

Sep 15, 2000·Archives of Neurology·C Cho, L M Samkoff
Sep 29, 2000·Movement Disorders : Official Journal of the Movement Disorder Society·P KrystkowiakL Defebvre
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Apr 23, 2013·Lancet Neurology·Raja Mehanna, Joseph Jankovic

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Citations

Dec 17, 2016·Expert Review of Neurotherapeutics·Stefano Caproni, Carlo Colosimo
Feb 21, 2018·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Shuo LiRajiv Mangla
Jun 6, 2018·European Neurology·Navnika Gupta, Sanjay Pandey
Feb 21, 2018·Operative Neurosurgery·Julien DelaunoisChristian Raftopoulos
Jan 12, 2021·Movement Disorders Clinical Practice·Thomas OsterholtDietrich Haubenberger
Mar 24, 2021·Neuro-Chirurgie·N Del GaudioC Raftopoulos

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