Clinical and magnetic resonance imaging manifestations of Holmes tremor

Yu Wan Yang, Fang Chia Chang, Chon Haw Tsai, Laura Wu, Chin Song Lu, Chi Chung Kuo, Ming Kuei Lu, Wei Liang Chen, Cheng Chun Lee

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Holmes tremor is a rare symptomatic slow tremor in the proximal parts of the limbs. It may be present at rest or maintenance of a posture, or during the movement of the affected limb. We describe here-in three patients of Holmes tremor with possible etiologies of brainstem infarction and head injury. The intervals between the causal events and the appearance of tremor range from 1 month to 12 months. Magnetic resonance imaging studies reveal hypertrophy of the inferior olivary nucleus in all of the three patients, although only one of them has palatal myoclonus. The surface electromyographic recordings reveal characteristic slow oscillation with frequencies of 3.5 to 4.2 Hz. These features suggest that perturbation of the dentato-rubral-olivary circuitry may play a pivotal role for the generation of Holmes tremor. However, no tight correlation is observed between the presence of inferior olivary nuclear hypertrophy and the appearance of symptomatic palatal myoclonus in the current report.

Keywords

  • Brainstem infarction
  • Dentate-rubral-olivary circuitry
  • Head injury
  • Holmes tremor
  • Inferior olivary nuclear hypertrophy

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Yang, Y. W., Chang, F. C., Tsai, C. H., Wu, L., Lu, C. S., Kuo, C. C., Lu, M. K., Chen, W. L., & Lee, C. C. (2005). Clinical and magnetic resonance imaging manifestations of Holmes tremor. Acta Neurologica Taiwanica, 14(1), 9-15.