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['Rubral' tremor after vascular thalamic lesions]
A Martínez Pérez-Balsa1, J F Martí-Massó, A López de Munain
1Servicio de Neurologia, Hospital Ntra. Sra. de Aránzazu, San Sebastián, España.
Introduction:
The appearance of tremor after thalamic lesions is well-known but infrequent. Amongst the semiological varieties of thalamic tremors, a particularly uncommon type--which is extremely incapacitating owing to its great amplitude, appearance during action and poor therapeutic response--is the so-called rubric or mesencephalic tremor.
Clinical Cases:
We present four cases, of tremor with the semiological characteristics of rubric tremors after thalamic lesions of ischaemic or haemorrhagic origin. We review the relevant literature.
Discussion:
The rubric tremor has been said to have its physiopathological origin in a lesion of the nigro-striate via and the efferent cerebellar vias at some point of the mesencephalic or subthalamic path, often without direct involvement of the red nucleus.
Conclusions:
The presentation of this type of tremor due to lesions which do not effect the red nucleus and the mesencephalum show the unsuitability of the name.