title: Holmes-like tremor of the lower extremity following brainstem hemorrhage.
abstract: Holmes tremor is an arrhythmic, 2- to 5-Hz resting, postural, and kinetic upper extremity movement disorder that occurs weeks to months after acute mesencephalic pathology. We present a patient who developed tremor in three body parts postbrainstem hemorrhage with subsequent hypertrophic olivary degeneration and discuss the relevant clinical evolution. Our case is unique because in addition to expected upper extremity and cervical dystonic head tremors, the patient also developed a severe lower extremity movement disorder, which we believe to be a form of Holmes tremor. Tremor involving the lower extremity in this setting has not been previously reported.
authors.affiliation: Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Walker
authors.forename: Hojoong
authors.initials: H
authors.lastname: Kim
authors.forename: Ali
authors.initials: A
authors.lastname: Samii
mesh_terms: D000208:Acute Disease; D000328:Adult; D001933:Brain Stem / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000473:pathology; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D009410:Nerve Degeneration / Q000473:pathology; D009847:Olivary Nucleus / Q000473:pathology; D010291:Paresis / Q000150:complications / Q000503:physiopathology; D011187:Posture; D013681:Tegmentum Mesencephali / Q000473:pathology; D014202:Tremor / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D034941:Upper Extremity / Q000503:physiopathology*