Holmes tremor after brainstem hemorrhage, treated with levodopa

Jae Hyun Woo, Bo Young Hong, Joon Sung Kim, Seok Ho Moon, Soo Yeon Kim, Hye Young Han, Dong Yoon Park, Seong Hoon Lim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Holmes tremor is a rare movement phenomenon, with atypical low-frequency tremor at rest and when changing postures, often related to brainstem pathology. We report a 70-year-old female patient who was presented with dystonic head and upper limb tremor after brainstem hemorrhage. The patient had experienced a sudden onset of left hemiparesis and right facial paralysis. Brain magnetic resonance imaging showed an acute hemorrhage from the brachium pontis through the dorsal midbrain on the right side. Several months later, the patient developed resting tremor of the head and left arm, which was exacerbated by a sitting posture and intentional movement. The tremor showed a regular low-frequency (1-2 Hz) for the bilateral sternocleidomastoid and cervical paraspinal muscles at rest. The patient's symptoms did not respond to propranolol or clonazepam, but gradually improved with levodopa administration. Although various remedies were attempted, overall, the results were poor. We suggest that levodopa might be a useful remedy for Holmes tremor. The curative or relieving effect of the dopaminergic agent in Holmes tremor needs more research.

Original languageEnglish (US)
Pages (from-to)591-594
Number of pages4
JournalAnnals of Rehabilitation Medicine
Volume37
Issue number4
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Levodopa
Tremor
Brain Stem
Hemorrhage
Posture
Head
Paraspinal Muscles
Clonazepam
Dopamine Agents
Facial Paralysis
Paresis
Mesencephalon
Propranolol
Upper Extremity
Arm
Magnetic Resonance Imaging
Pathology
Brain
Research

Keywords

  • Holmes tremor
  • Levodopa
  • Traumatic brain stem hemorrhage

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Woo, J. H., Hong, B. Y., Kim, J. S., Moon, S. H., Kim, S. Y., Han, H. Y., ... Lim, S. H. (2013). Holmes tremor after brainstem hemorrhage, treated with levodopa. Annals of Rehabilitation Medicine, 37(4), 591-594. https://doi.org/10.5535/arm.2013.37.4.591

Holmes tremor after brainstem hemorrhage, treated with levodopa. / Woo, Jae Hyun; Hong, Bo Young; Kim, Joon Sung; Moon, Seok Ho; Kim, Soo Yeon; Han, Hye Young; Park, Dong Yoon; Lim, Seong Hoon.

In: Annals of Rehabilitation Medicine, Vol. 37, No. 4, 2013, p. 591-594.

Research output: Contribution to journalArticle

Woo, JH, Hong, BY, Kim, JS, Moon, SH, Kim, SY, Han, HY, Park, DY & Lim, SH 2013, 'Holmes tremor after brainstem hemorrhage, treated with levodopa', Annals of Rehabilitation Medicine, vol. 37, no. 4, pp. 591-594. https://doi.org/10.5535/arm.2013.37.4.591
Woo, Jae Hyun ; Hong, Bo Young ; Kim, Joon Sung ; Moon, Seok Ho ; Kim, Soo Yeon ; Han, Hye Young ; Park, Dong Yoon ; Lim, Seong Hoon. / Holmes tremor after brainstem hemorrhage, treated with levodopa. In: Annals of Rehabilitation Medicine. 2013 ; Vol. 37, No. 4. pp. 591-594.
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