title: Unilateral thalamic Vim and GPi stimulation for the treatment of Holmes' tremor caused by midbrain cavernoma: case report and review of the literature.
abstract: A 30-year-old man with brainstem cavernoma experienced hemorrhage and was operated in 2008. Six months after the operation, the patient presented with new complaints of left arm tremor namely Holmes' tremor. Neurological examination also revealed left-sided internuclear ophthalmoplegia, left-sided mild paresis, and increased deep tendon reflexes of the left upper extremity, truncal ataxia, and dysarthria. Brain magnetic resonance imaging showed a postoperative cavity and gliosis at the level of the superior and inferior colliculus in the right tegmentum and right red nucleus with extension to the substantia nigra. Fahn-Tolosa-Marin tremor rating scale (TRS) for his left upper extremity (Part A, score 6) was 11 for the proximal and the distal arm. After the failure of medical treatment, the patient underwent right globus pallidum internus and ventral intermediate thalamic nucleus deep brain stimulation. There were no side effects related to the stimulation. Final TRS months after operation was 3 for the proximal and 4 for the distal arm.
authors: Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors: Sabri
authors: S
authors: Aydin
authors: Bashar
authors: B
authors: Abuzayed
authors: Gunes
authors: G
authors: Kiziltan
authors: Aysegul
authors: A
authors: Gunduz
authors: Selin
authors: S
authors: Yagci
authors: Murat
authors: M
authors: Mengi
authors: Osman
authors: O
authors: Kizilkilic
authors: Mustafa
authors: M
authors: Uzan
authors: Murat
authors: M
authors: Hanci
mesh_terms: D000328:Adult; D046690:Deep Brain Stimulation; D005917:Globus Pallidus / Q000502:physiology*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications* / Q000601:surgery; D006801:Humans; D007033:Hypothalamus, Middle / Q000502:physiology*; D002538:Intracranial Arteriovenous Malformations / Q000150:complications* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D019635:Neurosurgical Procedures / Q000379:methods; D013238:Stereotaxic Techniques; D014202:Tremor / Q000209:etiology* / Q000601:surgery / Q000628:therapy*