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BMC Neurology
Published in: BMC Neurology 1/2015

Open Access 01-12-2015 | Case report

Vim thalamotomy in a patient with Holmes’ tremor and palatal tremor - Pathophysiological considerations

Authors: Futaba Maki, Sumito Sato, Katsushige Watanabe, Toshiyuki Yanagisawa, Yuta Hagiwara, Takahiro Shimizu, Yasuhiro Hasegawa

Published in: BMC Neurology | Issue 1/2015

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Abstract

Background

We peformed a ventral intermediate nucleus (Vim) thalamotomy in a patient with Holmes’ tremor and palatal tremor. The frequencies of these movement disorders were 4 Hz and 3 Hz, respectively. Vim thalamotomy stopped the Holmes’ tremor but not the palatal tremor. Our observations suggest different mechanisms for these two involuntary movements.

Case presentation

A 57-arm 11 months after a pontine hemorrhage. Transoral carotid ultrasonography revealed periodic motion of her posterior pharyngeal wall with a frequency of 3 Hz. Recording of neuronal activities in the thalamus revealed a 4Hz rhythmic discharge time that was associated with her tremor in the contralateral arm. A left Vim thalamotomy was performed. The resting tremor of the upper limb stopped, but the kinetic tremor recurred 6 months after the thalamotomy. No effect was observed on her palatal tremor.

Conclusions

The different effects of Vim thalamotomy on the Holmes’ tremor and palatal tremor suggest different oscillation sources for these two involuntary movements.
Literature
1.
Deuschl G, Bain P, Brin M. Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee. Mov Disord. 1998;13 Suppl 3:2–23.PubMed
2.
Vidailhet M, Jedynak CP, Pollak P, Agid Y. Pathology of symptomatic tremors. Mov Disord. 1998;13 Suppl 3:49–54.PubMed
3.
Suda S, Yamazaki M, Katsura K, Fukuchi T, Kaneko N, Ueda M, et al. Dramatic response to zonisamide of post-subarachnoid hemorrhage Holmes’ tremor. J Neurol. 2012;259(1):185–7.CrossRefPubMed
4.
Deuschl G, Bergman H. Pathophysiology of nonparkinsonian tremors. Mov Disord. 2002;17 Suppl 3:S41–8.CrossRefPubMed
5.
Schreuder FH, Hamers RM, van Domburg PH. Teaching NeuroImages: Holmes tremor after midbrain stroke. Neurology. 2010;75:e10.CrossRefPubMed
6.
Yasaka M, Kimura K, Otsubo R, Isa K, Wada K, Nagatsuka K, et al. Transoral carotid ultrasonography. Stroke. 1998;29:1383–8.CrossRefPubMed
7.
Fahn S, Tolosa E, Marin C. Clinical rating scale for tremor. In: Jankovic J, Tolosa E, editors. Parkinson’s Disease and Movement Disorders. Baltimore: Williams & Wilkins; 1993. p. 271–80.
8.
Matsuo F, Ajax ET. Palatal myoclonus and denervation supersensitivity in the central nervous system. Ann Neurol. 1979;5:72–8.CrossRefPubMed
9.
Rothwell JC. Physiology and anatomy of possible oscillators in the central nervous system. Mov Disord. 1998;13 Suppl 3:24–8.PubMed
10.
Deuschl G, Raethjen J, Lindemann M, Krack P. The pathophysiology of tremor. Muscle Nerve. 2001;24:716–35.CrossRefPubMed
11.
12.
Rieder CR, Reboucas RG, Ferreira MP. Holmes tremor in association with bilateral hypertrophic olivary degeneration and palatal tremor: chronological considerations. Case report. Arq Neuropsiquiatr. 2003;61:473–7.CrossRefPubMed
13.
Shepherd GM, Tauboll E, Bakke SJ, Nyberg-Hansen R. Midbrain tremor and hypertrophic olivary degeneration after pontine hemorrhage. Mov Disord. 1997;12:432–7.CrossRefPubMed
14.
Foote KD, Okun MS. Ventralis intermedius plus ventralis oralis anterior and posterior deep brain stimulation for posttraumatic Holmes tremor: two leads may be better than one: technical note. Neurosurgery. 2005;56:E445. discussion E445.CrossRefPubMed
15.
Peker S, Isik U, Akgun Y, Ozek M. Deep brain stimulation for Holmes’ tremor related to a thalamic abscess. Childs Nerv Syst. 2008;24:1057–62.CrossRefPubMed
16.
Sanborn MR, Danish SF, Ranalli NJ, Grady MS, Jaggi JL, Baltuch GH. Thalamic deep brain stimulation for midbrain tremor secondary to cystic degeneration of the brainstem. Stereotact Funct Neurosurg. 2009;87:128–33.CrossRefPubMed
17.
Romanelli P, Bronte-Stewart H, Courtney T, Heit G. Possible necessity for deep brain stimulation of both the ventralis intermedius and subthalamic nuclei to resolve Holmes tremor. Case report. J Neurosurg. 2003;99:566–71.CrossRefPubMed
18.
Goto S, Yamada K. Combination of thalamic Vim stimulation and GPi pallidotomy synergistically abolishes Holmes’ tremor. J Neurol Neurosurg Psychiatry. 2004;75:1203–4.CrossRefPubMedPubMedCentral
19.
Miyagi Y, Shima F, Ishido K, Moriguchi M, Kamikaseda K. Posteroventral pallidotomy for midbrain tremor after a pontine hemorrhage. Case report. J Neurosurg. 1999;91:885–8.CrossRefPubMed
20.
Brittain JS, Jenkinson N, Holland P, Joundi RA, Green AL, Aziz TZ. Development of Holmes’ tremor following hemi-cerebellar infarction. Mov Disord. 2011;26:1957–9.CrossRefPubMed
Metadata
Title
Vim thalamotomy in a patient with Holmes’ tremor and palatal tremor - Pathophysiological considerations
Authors
Futaba Maki
Sumito Sato
Katsushige Watanabe
Toshiyuki Yanagisawa
Yuta Hagiwara
Takahiro Shimizu
Yasuhiro Hasegawa
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2015
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-015-0277-5

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