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Standing Neurophysiological Assessment of Lower Extremity Muscles Post-Stroke
Published on: July 26, 2021
Post-ischemic Holmes' tremor of the lower extremities
Journal of Neurology
|August 8, 2009
Summary
Holmes
Area of Science:
- Neurology
- Neuroscience
- Movement Disorders
Background:
- Holmes' tremor is a low-frequency tremor (below 4.5 Hz) associated with lesions in the brain stem, cerebellum, and thalamus.
- Published literature primarily details Holmes' tremor affecting the upper extremities.
Observation:
- A patient presented with a tremor predominantly in the lower extremities.
- The tremor was secondary to an ischemic infarct affecting the cerebellum, thalamus, and midbrain.
Findings:
- Standard treatments including levodopa, quetiapine, and levetirecetam were ineffective.
- Pribedil, a dopaminergic receptor-stimulating agent, successfully improved the patient's tremor.
- This case highlights Holmes' tremor manifesting severely in lower extremities, a rare presentation.
Implications:
- Dopaminergic receptor-stimulating agents represent a potential therapeutic option for Holmes' tremor.
- This finding suggests considering dopaminergic agents before exploring invasive treatments for refractory tremors.
- The case expands the understanding of Holmes' tremor presentation and treatment possibilities.
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