Yes/yes head tremor without appendicular tremor after bilateral cerebellar infarction.
We report a 67-year-old man who developed yes/yes head tremor without appendicular tremor six weeks after right occipital and bilateral cerebellar infarction. The tremor was resting-postural. Its activity increased with excitement, decreased either after ethanol, lateroflexion or rest and stopped at sleep. Four-vessel angiography revealed a well collateralised occlusion of both vertebral arteries. Needle-EMG recordings showed rhythmic, synchronous agonist/antagonist activity in both the splenius capitis and sternocleidomastoideus muscles at a frequency of 2-3 Hz. After administration of botulinum toxin A (DysportR), the tremor markedly improved and vanished completely after a booster. Since then the tremor did not reappear. Delayed-onset, yes/yes head tremor without appendicular tremor may be caused by bilateral cerebellar infarction and can be successfully relieved with botulinum toxin A.
Finsterer
J
J
2. Neurological Department, Neurological Clinic Rosenhuegei, Vienna, Austria.
Muellbacher
W
W
Mamoli
B
B
D001905:Botulinum Toxins / Q000627:therapeutic use; D002526:Cerebellar Diseases / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D002531:Cerebellum / Q000098:blood supply*; D002544:Cerebral Infarction / Q000150:complications*; D006257:Head / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009847:Olivary Nucleus / Q000503:physiopathology; D012012:Red Nucleus / Q000503:physiopathology; D014202:Tremor / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology
D001905:Botulinum Toxins