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Midbrain tremor: a tremor resistant to treatment
Abdul Qayyum Rana1, Zain Badar
1Parkinson's Clinic of Eastern Toronto & Movement Disorders Center, 404-2863 Ellesmere Rd, Toronto, ON M1E5E9, Canada. ranaaq@yahoo.com
Acta Neurologica Belgica
|March 20, 2012
Summary
Midbrain tremor, often difficult to treat, presents challenges in upper extremity movement. One patient achieved significant tremor reduction with trihexyphenidyl, suggesting individualized treatment approaches for this neurological condition.
Area of Science:
- Neurology
- Neurosurgery
Background:
- Midbrain tremor is characterized by resting, postural, action, and intentional tremors of the upper extremity.
- Pharmacological treatments often yield only partial responses, complicating management.
Observation:
- Three cases of midbrain tremor are presented, linked to ischemic/hemorrhagic strokes and head trauma.
- Patients experienced tremors in their upper extremities due to midbrain and thalamic area involvement.
Findings:
- Standard treatments including benztropine, amantadine, pramipexole, and levodopa were largely ineffective across the first two cases.
- The third patient showed a 70% improvement in midbrain tremor with trihexyphenidyl after initial lack of response to amantadine.
Implications:
- Treatment for midbrain tremor requires a case-by-case assessment.
- Exploring all therapeutic options after a thorough risk-benefit analysis is crucial for effective management.
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