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Updated: Jul 6, 2026

MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
[Frontal cortical infarction and contralateral postural and international tremor]
J M López Domínguez1, I Rojas-Marcos, G Sanz Fernández
1Sección de Neurología, Hospital Juan Ramón Jiménez, Huelva, Spain. Jlopezd30@telefonica.net
Introduction:
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.
Case Report:
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.
Discussion:
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.
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