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Holmes tremor secondary to brainstem hemorrhage responsive to levodopa: report of 2 cases

Gabriela B Raina1, Miriam Velez, Manuel Fernandez Pardal

  • 1Parkinson's Disease and Movement Disorders Unit, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.

Clinical Neuropharmacology
|April 7, 2007
PubMed

We report 2 patients who presented a brainstem hemorrhage and who, after 1 and 6 months, respectively, developed a 4-Hz postural and resting tremor consistent with Holmes tremor, which severely interfered with the activities of daily living. In both cases, levodopa dramatically improved the tremor. Pharmacological treatment of this condition is usually disappointing, and surgical procedures are commonly required for severe cases. Our patients, together with 13 others gleaned from the literature, suggest that in cases of Holmes tremor secondary to brainstem hemorrhage, levodopa can be a useful treatment, and it should be tested before considering invasive therapies.

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