title: Holmes tremor: Application of modern neuroimaging techniques.
abstract: Holmes tremor has a characteristic rest, intention, and postural component. The syndrome arises as a consequence of a lesion in the upper brainstem and cerebral peduncles, which, it is postulated, interrupts the cerebello-rubrothalamic pathway. Ataxia, ophthalmoplegia, and bradykinesia are associated features. We present a case of Holmes tremor secondary to a midbrain cavernoma. Modern neuroimaging techniques in this case confirm that a combination of damage to the cerebello-rubrothalamic pathway and the nigrostriatal pathway is required for the full Holmes tremor syndrome to occur.
authors.affiliation: The Sara Koe PSP Research Centre, The Institute of Neurology, UCL, London, United Kingdom. dpaviour@dementia.ion.ucl.ac.uk
authors.forename: Dominic C
authors.initials: DC
authors.lastname: Paviour
authors.forename: H Rolf
authors.initials: HR
authors.lastname: Jäger
authors.forename: Leonora
authors.initials: L
authors.lastname: Wilkinson
authors.forename: Marjan
authors.initials: M
authors.lastname: Jahanshahi
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lees
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D014202:Tremor / Q000175:diagnosis*