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Ann Rehabil Med.  2014 Oct;38(5):694-697. 10.5535/arm.2014.38.5.694.

Effect of Ultrasonography-Guided Botulinum Toxin Type A Injection in Holmes' Tremor Secondary to Pontine Hemorrhage: Case Report

Affiliations
  • 1Department of Rehabilitation Medicine, Rehabilitation Hospital, National Rehabilitation Center, Seoul, Korea. asfreelyas@gmail.com
  • 2Division of Education & Public Relations, National Rehabilitation Center, Seoul, Korea.

Abstract

Holmes' tremor is a low-frequency rest and intentional tremor secondary to various insults, including cerebral ischemia, hemorrhage, trauma, or neoplasm. Pharmacologic treatment is usually unsuccessful, and some cases require surgical intervention. We report a rare case of Holmes' tremor secondary to left pontine hemorrhage in a 29-year-old Asian male patient who developed 1.6-Hz postural and rest tremor of the right hand. He responded markedly to ultrasonography-guided botulinum toxin type A injection. To our knowledge, this is the first report of Homes' tremor treated with ultrasonography-guided botulinum toxin type A injection with favorable results.

Keyword

Tremor; Botulinum toxins; Ultrasonography

MeSH Terms

Adult
Asian Continental Ancestry Group
Botulinum Toxins
Botulinum Toxins, Type A*
Brain Ischemia
Hand
Hemorrhage*
Humans
Male
Tremor*
Ultrasonography
Botulinum Toxins
Botulinum Toxins, Type A
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