Deep brain stimulation of the nucleus ventralis intermedius for Holmes (rubral) tremor and associated dystonia caused by upper brainstem lesions. Report of two cases.
Holmes tremor is caused by structural lesions in the perirubral area of the midbrain. Patients often present with associated symptoms such as dystonia and paresis, which are usually refractory to medical therapy. Here, the authors describe two patients in whom both tremor and associated dystonia improved markedly following unilateral stimulation of the thalamic nucleus ventralis intermedius.
Nikkhah
Guido
G
Department of Stereotactic and Functional Neurosurgery, Neurocenter, Albert-Ludwigs-University, Freiburg, Germany. nikkhah@ukl.uni-freiburg.de
Prokop
Thomas
T
Hellwig
Bernhard
B
Lücking
Carl Hermann
CH
Ostertag
Christoph B
CB
D001259:Ataxia / Q000209:etiology / Q000628:therapy*; D001933:Brain Stem / Q000473:pathology*; D002544:Cerebral Infarction / Q000150:complications*; D004421:Dystonia / Q000209:etiology; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D020651:Ventral Thalamic Nuclei / Q000502:physiology*