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Artigo Produção Nacional Revisado por pares
BIBTEX RIS

Holmes’ tremor as a delayed complication of thalamic stroke

2015; Elsevier BV; Volume: 26; Linguagem: Inglês

10.1016/j.jocn.2015.09.014

ISSN

1532-2653

Autores

William Alves Martins, Luiz Carlos Porcello Marrone, Helena Fussiger, Viviane Vedana, Rafael do Amaral Cristovam, Marjorye Z. Taietti, A. Marrone,

Tópico(s)

Neurological and metabolic disorders

Resumo

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.

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