[Frontal cortical infarction and contralateral postural and international tremor].
BACKGROUND
Movement disorders, when caused by ischemic stroke, may appear as initial manifestation or after a variable interval of time. Among postictal movement disorders tremor is an uncommon manifestation. Holmes' tremor, which is a mixed tremor, is the most frequent type of tremor after stroke. It is associated to infarcts of various localizations like mesencephalon, pons, cerebellum, and thalamus. Cortical infarct is exceptional as a cause of tremor.


METHODS
A sixty-three-year-old woman, with hypertension, who, 2 weeks after a cortical infarct located in the precentral circunvolution of the left frontal lobe, presented with a postural and intention tremor of low frequency (4 Hz) and high amplitude at the right arm. Tremor is still present 2 years after stroke and it has improved partially after treatment with clonazepam.


CONCLUSIONS
Frontal cortical infarcts may cause a contralateral postural and intentional tremor. It usually appears after a time interval. Tremor physiopathology may be related, in these cases, to interruption of the inhibitory fronto-subcortical motor circuit.
López Domínguez
J M
JM
Sección de Neurología, Hospital Juan Ramón Jiménez, Huelva, Spain. Jlopezd30@telefonica.net
Rojas-Marcos
I
I
Sanz Fernández
G
G
Robledo Strauss
A
A
D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014202:Tremor / Q000209:etiology / Q000503:physiopathology