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Holmes tremor: an updated review
Efstratios-Stylianos Pyrgelis1, Eleni Agapiou2, Efthalia Angelopoulou3
11st Department of Neurology, "Eginition" Hospital, School of medicine, National and Kapodistrian University of Athens, 72 Vas. Sophias Ave, 11528, Athens, Greece. stratospyrg@yahoo.gr.
Summary
Holmes tremor is a rare movement disorder affecting the brain. Diagnosis relies on imaging like MRI, and new research may improve its challenging treatment.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Holmes tremor is a rare, high-amplitude, low-frequency movement disorder.
- It involves rest, intention, and postural tremor components.
- Pathophysiology links to dopaminergic nigrostriatal and cerebellothalamocortical pathways.
Purpose of the Study:
- To review the characteristics, diagnosis, and management of Holmes tremor.
- To highlight the role of neuroimaging and functional studies.
- To discuss the challenges and future directions in treating this condition.
Main Methods:
- Clinical examination findings.
- Neurophysiological assessments.
- Neuroimaging studies including MRI and dopamine transporter imaging (123I-FP CIT).
Main Results:
- MRI is crucial for lesion localization and etiology identification.
- Dopamine transporter imaging assesses nigrostriatal pathway integrity.
- Etiologies include cerebrovascular events, tumors, demyelination, and infections.
Conclusions:
- Holmes tremor diagnosis integrates clinical, neurophysiological, and imaging data.
- Despite available treatments, management remains challenging.
- Advancements in understanding neural circuits, genetics, and molecular aspects promise improved clinical evaluation and management.
