Holmes tremor

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First identified by Gordon Holmes in 1904, Holmes' tremor can be described as a flexion-extension oscillatory movement[1] but more specifically, flexion and extension of the fingers with rotation at the wrist and elbow.[2] Holmes' tremor is a combination of rest, action, and postural tremors. Tremor frequency ranges from 3 to 4 Hertz and is enhanced with posture and aggravated with movement.[1] It is a "wing-beating" type of tremor that is caused by cerebellar damage.[3] It may arise from various underlying structural disorders including multiple sclerosis, stroke, tumors,cerebellar hemorrhage and ischemia, trauma, neuroleptics, neoplasm, radiation and rare cases of midbrain germinoma.[2] Tremor onset typically occurs 6 to 12 months after insult.[1]

So far, few studies on Holmes' tremor secondary to cavernoma have been reported.[4] Also, since Holmes’ tremor is rare, much of the research is based on individual cases.[2]

Treatments include pharmacotherapy such as levadopa, thalamotomy or chronic thalamic stimulation.[1] Levadopa is often not effective [1][2][5] but has helped in some cases.[2]

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Sheppard, Gordon M G; Erik Tauboll, Soren Jacob Bakke, Rolf Nyberg-Hansen (1997). "Midbrain Tremor and Hypertrophic Olivery Degeneration After Pontine Hemorrhage". Movement Disorders 12 (3): 432–437. 
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Kim, M C; B C Son, Y Miyagi, J-K Kang (2002). "Vim thalamotomy for Holmes' tremor secondary to midbrain tumor". Journal of Neurology, Neurosurgery & Psychiatry 73: 453–455. 
  3. ↑ Tremor-Etiologies
  4. ↑ Leung GK, Fan YW, Ho SL. Rubral tremor associated with cavernous angioma of the midbrain. Mov Disord 1999; 14: 191-193. modified by Chinese Medical Jordan
  5. ↑ Brittain, John-Stuart; Ned Jenkinson, Petter Holland, Raed A Joundi, Alex L Green, Tipu Aziz (2011). "Development of Holmes' tremor following hemi-cerebellar infarction". Movement Disorder 26 (10): 1957–1959. 


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