(99m)Tc-TRODAT-1 SPECT study in evaluation of Holmes tremor after thalamic hemorrhage.
Holmes tremor is also known as rubral or midbrain tremor. The tremor usually involves lesions near the red nucleus and the nerve fiber tracts originating in the cerebellum and the substantia nigra. We report a case of a 62-year-old woman who presented with Holmes tremor 5 months after a left thalamic hemorrhage, with a partial recovery 3 years later. Sequential technetium-(99m)TRODAT-1 single-photon emission computed tomography (SPECT) of the patient's brain revealed partially improved tracer uptake reduction in the striatums, particularly on the left side. We propose that involvement of both the nigrostriatal and the dentate-rubro-thalamic pathways are essential in the pathogenesis of Holmes tremor after a thalamic lesion, and regeneration of the nigrostriatal system is possible in this type of tremor after the initial degeneration. The (99m)Tc-TRODAT-1 SPECT study is a useful and convenient tool for evaluating the nigrostriatal dopamine function in patients with Holmes tremor.
Sung
Yueh-Feng
YF
Department of Neurology, Tri-Service General Hospital, No. 325, Section 2, Neihu 114, Taipei, Taiwan, sungyf@ndmctsgh.edu.tw
Hsu
Yaw-Don
YD
Huang
Wen-Sheng
WS
D001259:Ataxia / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006470:Hemorrhage / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D015609:Organotechnetium Compounds; D013786:Thalamic Diseases / Q000150:complications*; D013788:Thalamus / Q000000981:diagnostic imaging; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014326:Tropanes
D015609:Organotechnetium Compounds; D014326:Tropanes; C104196:technetium Tc 99m TRODAT-1